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目的:探讨子宫全切除手术对患者卵巢内分泌功能、围绝经期症状及生存质量的影响。方法:根据手术方式将102例子宫良性病变患者分为子宫全切除手术组(观察组)54例以及子宫次切除组(对照组)48例,术后对两组患者随访12个月,采用放射免疫法测定患者血清中黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)、孕酮(P)的水平,同时采用Kupperman perman症状评分表及健康调查简表(SF-36)对两组患者围绝经期症状及生存质量进行评价。结果:观察组术后6个月及12个月血清LH、FSH水平显著高于治疗前及对照组,而E2水平显著下降,比较差异有统计学意义(P<0.05)。与对照组相比,观察组术后3个月、6个月、12个月Kupperman perman症状评分显著高于对照组,差异有统计学意义(P<0.05)。两组患者术前SF-36总评分无统计学意义(P>0.05),而观察组术后3个月、6个月、12个月SF-36总评分显著低于对照组,差异有统计学意义(P<0.05)。结论:子宫全切除手术可对影响卵巢内分泌功能,加重围绝经期患者的临床症状,降低患者生存质量,因此对于子宫良性变化患者在病情允许下,尽量保留子宫对提高患者术后生存质量有重要的意义。
Objective: To investigate the effect of total hysterectomy on ovarian endocrine function, perimenopausal symptoms and quality of life. Methods: A total of 102 patients with benign uterine fibroids were divided into hysterectomy group (observation group), 54 cases and uterus resection group (control group) according to the operation way. 48 cases were followed up for 12 months after operation. Serum levels of LH, FSH, E2 and progesterone were measured by immunoassay. Kupperman perman symptom scores and SF- 36) Perimenopausal symptoms and quality of life in both groups were evaluated. Results: The levels of serum LH and FSH in observation group at 6 and 12 months after operation were significantly higher than those before treatment and control group, while E2 levels were significantly decreased (P <0.05). Compared with the control group, the score of Kupperman perman symptom at 3 months, 6 months and 12 months after operation in observation group was significantly higher than that in control group (P <0.05). The total score of SF-36 in the two groups was not statistically significant (P> 0.05), but the total score of SF-36 in the observation group at 3 months, 6 months and 12 months after operation was significantly lower than that of the control group Significance (P <0.05). Conclusion: The total hysterectomy can affect the ovarian endocrine function, exacerbate the clinical symptoms of perimenopausal patients and reduce the quality of life of patients, so for patients with benign uterine changes in the condition permit, try to keep the uterus to improve the quality of life of patients after surgery is important Meaning.