不同术式处理对无妊娠需求子宫肌瘤患者卵巢功能及性功能的影响

摘要

Objectives:To investigate the effect of different operation modes on ovarian function and sexual function in patients with uterine fibroids and without need of pregnancy.Methods:A total of 92 patients with uterine fibroids and without need of pregnancy were divided into group A (n =46) and group B (n =46) according to different operation modes.The two groups were respectively treated by subtotal hysterectomy and myomectomy.The operation effects of the two groups were observed.The levels of serum ovarian function indexes were detected before operation and 6 months after operation.The sexual function was evaluated with the female sexual function scale.Results:There was no significant difference in the operation time and complications between the two groups (P ＞0.05).There were significant differences in blood loss and postoperative exhaust time (P ＜ 0.05).There was no significant difference in the levels of follicle stimulating hormone (FSH),luteinizing hormone (LH) and estradiol (E2) between the two groups before operation (P ＞ 0.05).The levels of FSH and LH were significantly increased while E21eve1 was significantly decreased in group A after operation (P ＜ 0.05).In group B,there was no significant difference in the levels of FSH,LH and E2 between before and after operation (P ＞ 0.05).The levels of FSH,LH and E2 showed significant differences between group A and group B (P ＜ 0.05).There was no significant difference in sexual function between the two groups before operation (P ＞ 0.05).After operation,the scores of sexual desire,sexual arousal and vaginal intercourse excitement in the two groups were significantly increased (P ＜0.05).In group A,the scores of abnormal symptoms and ejaculation time were decreased significantly after operation,and the scores were higher in group B than group A (P ＜ 0.05).Conclusion:Compared with subtotal hysterectomy,myomectomy has little effect on the ovarian function and sexual function in patients with uterine fibroids and without need of pregnancy.%目的:探讨不同术式处理对无妊娠需求子宫肌瘤患者卵巢功能及性功能的影响差异.方法:92例无妊娠需求子宫肌瘤患者按手术方式不同分为A组(n=46)、B组(n=46),分别行次全子宫全切除术、子宫肌瘤剔除术.观察两组手术效果,术前、术后6个月测定两组血清卵巢功能指标,并以国际女性性功能评价量表评估性功能情况.结果:两组手术时间、并发症比较无统计学差异(P＞0.05),出血量、术后排气时间比较有统计学差异(P＜0.05).两组术前促卵泡生长激素(FSH)、促黄体生长素(LH)、雌二醇(E2)激素水平比较无统计学差异(P＞0.05);A组术后FSH、LH水平显著升高,E2水平显著下降(P＜0.05),而B组术后FSH、LH、E2水平与术前相比无统计学差异(P＞0.05);A组、B组术后FSH、LH、E2水平比较有统计学差异(P＜0.05).两组术前性功能各项评分比较无统计学差异(P＞0.05);两组术后性欲、性唤起和阴道性交达兴奋、性高潮评分均显著升高(P＜0.05),A组术后性行为中异常症状、射精时间评分较术前明显下降,且B组评分高于A组(P＜0.05).结论:与次全子宫全切除术相比,子宫肌瘤剔除术对无妊娠需求子宫肌瘤患者卵巢功能及性功能的影响较小,因而更具有临床应用价值.