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目的探讨激素替代治疗(HRT)在绝经后妇女阴式手术前后应用的利弊。方法对绝经后妇女合并有子宫脱垂及不同程度阴道前后壁膨出、张力性尿失禁而实行手术治疗的患者随机分为实验组和对照组,每组25例。实验组在手术前后进行HRT,对照组予安慰剂,观察内分泌各项指标。结果与对照组比较,实验组阴道细胞成熟指数(MI)、致密核指数(KI)、角化指数(CI)明显提高,血清雌二醇(E2)也明显升高,血清卵泡剂激素(FSH)降低,均有显著性差异(P<0.05)。手术时间、术中出血量明显降低,住院天数缩短,有显著性差异(P<0.05)。术后6个月两组B超监测子宫内膜厚度基本一致。结论对绝经后妇女,做阴式手术前后应用HRT并局部用药安全可行,利大于弊。
Objective To investigate the advantages and disadvantages of hormone replacement therapy (HRT) before and after vaginal surgery in postmenopausal women. Methods The postmenopausal women with uterine prolapse and varying degrees of vaginal anterior and posterior wall bulging, urinary incontinence and the implementation of surgical treatment of patients were randomly divided into experimental group and control group, 25 cases in each group. The experimental group was treated with HRT before and after surgery and the control group with placebo. The indexes of endocrine were observed. Results Compared with the control group, the vaginal cell maturation index (MI), dense nucleus index (KI) and keratosis index (CI) in the experimental group were significantly increased, serum estradiol (E2) was also significantly increased, serum follicle-stimulating hormone ) Decreased, there was significant difference (P <0.05). Operation time, intraoperative blood loss decreased significantly, shorter days of hospitalization, there was a significant difference (P <0.05). At 6 months after operation, the thickness of B-endometrium in both groups was basically the same. Conclusion For postmenopausal women, it is safe and feasible to use HRT before and after vaginal surgery to do local drug administration, which outweigh the disadvantages.