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目的探讨子宫切除与围绝经期综合征(PMS)的关系。方法选取2010年5月-2011年5月间在本院妇科经腹行子宫切除术128例,随机分为子宫全切及次全切组,各64例,另选同期健康体检者60例为正常对照,采用化学发光法测定卵泡刺激素(FSH)、黄体生成素(LH)及雌二醇(E2)水平并比较组间差异。采用改良Kupperman评分表调查PMS的发生率。结果单因素方差分析FSH、LH、E2水平在三组之间的差异,均有统计学意义(Fa=28.56;Fb=61.57;Fc=70.39,P<0.001);子宫全切组与次全切组关于FSH、E2的比较,差异有统计学意义(P<0.01;P<0.001),LH两组比较差异无统计学意义(P>0.05)。1年后PMS发生率对照组、子宫全切组及次全切组分别为10.3%、24.2%及30.5%。子宫全切组及次全切组与对照组分别比较,差异均有统计学意义(χ2=7.29,P<0.01;χ2=3.89,P<0.05);子宫全切组与次全切组比较,差异无统计学意义(χ2=0.608,P>0.05)。结论子宫切除可促使PMS的发生。
Objective To investigate the relationship between hysterectomy and perimenopausal syndrome (PMS). Methods From May 2010 to May 2011, 128 cases underwent gynecological abdominal hysterectomy in our hospital were randomly divided into hysterectomy and subtotal resection, each of 64 cases, and the other 60 cases Normal control, the levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) were determined by chemiluminescence method and the differences among groups were compared. The incidence of PMS was investigated using a modified Kupperman scale. Results One-way analysis of variance (ANOVA) FSH, LH and E2 levels in the three groups were statistically significant (Fa = 28.56; Fb = 61.57; Fc = 70.39, P <0.001) Group FSH, E2, the difference was statistically significant (P <0.01; P <0.001), LH was no significant difference between the two groups (P> 0.05). The incidence of PMS after 1 year was 10.3%, 24.2% and 30.5% in the control group, the uterotomy group and the subtotal resection group, respectively. Uterine total resection group and sub-total resection group compared with the control group, the differences were statistically significant (χ2 = 7.29, P <0.01; χ2 = 3.89, P <0.05); uterine resection group and subtotal resection group, The difference was not statistically significant (χ2 = 0.608, P> 0.05). Conclusion Hysterectomy can promote the occurrence of PMS.