预防性卵巢切除术对绝经后妇女激素水平及生活质量的影响

摘要

目的：探讨绝经后妇女预防性卵巢切除术后激素水平的变化。方法选取2010年12月~2011年3月于大连市妇产医院行预防性双侧卵巢摘除术的良性子宫病变患者29例为研究对象,所有患者均为绝经后妇女。根据绝经年限将其分为三组：A组(1~3年)9例、B组(>3~10年)10例、C组(>10年)10例。采用Kupperman评分表对三组患者手术前后的自我感觉进行评价；检测并比较术前、术后3个月及术后12个月三组患者卵泡刺激素(FSH)、雌激素(E2)和睾酮的水平。结果术后3个月,A、B两组总Kupperman评分均明显高于术前(P<0.05)；C组患者手术前后湿热出汗、心悸、疲乏及泌尿系疾病评分比较,差异有统计学意义(P<0.05)；术前C组心悸与A组比较,差异有统计学意义(P<0.05),C组泌尿系症状与B组比较,差异有统计学意义(P<0.05)。术后3个月, A组患者E2、FSH及睾酮水平均较术前明显下降(P<0.05),B组患者E2及睾酮水平均较术前降低(P<0.05),而术后12个月又升高；FSH则表现出相反的变化趋势,术后3个月升高,术后12个月下降,但术后12个月高于术前(P<0.05)。结论绝经期尤其是绝经时间在3年以内的患者预防性的卵巢剔除术后雄激素与雌激素均显著降低,而FSH明显增高,绝经症状明显加重,从而降低生活质量。%Objective To explore the change of hormone levels of the postmenopausal women after prophylactic oophorectomy. Methods From December 2010 to March 2011, 29 patients with benign uterine lesions and given pro-phylactic bilateral ovaries line excision in Dalian Maternity Hospital were selected as the research objects, and all of the patients were postmenopausal women. According to duration of menopause, they were divided into three groups:group A (1-3 years), 9 cases;group B (>3-10 years), 10 cases;group C (>10 years), 10 cases. Kupperman scoring was used to evaluate the feel of patients in three groups before and after surgery; the follicle-stimulating hormone (FSH), estrogen (E2) and testosterone levels at preoperative, 3 months postoperative and 12 months postoperative of pa-tients in three groups were tested and compared. Results 3 months postoperative, the total Kupperman scores of group A and B were significantly higher than that of preoperative (P< 0.05); scores of hot and sweating, heart palpitations, fatigue and urinary tract disease of patients in group C before and after surgery had statistically significant differences (P<0.05);before operation, score of heart palpitations between group C and group A had statistically significant differ-ences (P < 0.05), urinary tract symptoms between group C and group B had statistically significant differences (P <0.05). 3 months postoperative levels of E2, FSH and testosterone of patients in group A were obviously decreased than those before operation (P< 0.05), levels of E2 and testosterone of patients in group B were obviously decreased than those before operation (P < 0.05), and 12 months postoperative risen again; FSH showed opposite change tendency, higher at 3 months postoperative, fall at 12 months postoperative, but was also higher than preoperative (P < 0.05). Conclusion Menopause patients especially patients with duration of menopause less than 3 years, within 3 years andro-gen and estrogen will significantly decrease after preventive ovaries remove, and increases FSH significantly, aggravate the menopausal symptoms, and lower the quality of life.