不同全子宫切除术的性功能及卵巢功能对比分析
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摘要
目的探究不同方式全子宫切除术对患者性功能及卵巢功能的影响。方法选取2015年3月至2017年3月什邡市人民医院诊治的90例全子宫切除术患者作为研究对象。根据手术方式的不同将患者分为TLH(腹腔镜下全子宫切除术)组、TVH(阴式全子宫切除术)组和TAH(开腹全子宫切除术组),每组各30例。对三组患者手术相关指标、术后性功能以及手术前后卵巢功能进行综合评价。结果 TLH组患者手术时间、术中出血量等相关指标均显著少于TAH组,在术中出血量及住院时间方面达到最佳,差异具有统计学意义(P<0.05);术后性功能比较,TLH组与TVH组均显著优于TAH组,差异具有统计学意义(P<0.05),但TLH组与TVH组组间比较差异无统计学意义(P>0.05);术后6个月卵巢功能比较,TLH组E2、FSH与TAH组比较有具统计学意义(P<0.05)。结论腹腔镜下全子宫切除手术对患者卵巢内分泌功能影响相对较小,能够促进患者性功能恢复,疗效显著,值得推广应用。
Objective To explore the effect of different total hysterectomy on the sexual function and ovarian function of patients. Methods 90 patients received total hysterectomy in our hospital from March 2015 to March 2017 were selected, and according to the different methods of surgery, were divided into total laparoscopic hysterectomy group(TLH group, 30 cases), transvaginal hysterectomy group(TVH group, 30 cases) andtransabdominal hysterectomy group(TAH group, 30 cases). Surgery related indicators, postoperative sexual function and ovarian function was comprehensively evaluated before and after operation. Results The operation time and intraoperative blood loss in the TLH group was shorter and less than that in the TAH group, with statistically significant difference(P< 0.05). The postoperative sexual function in the TLH group and TVH group was significantly better than that in the TAH group, with statistically signifincat difference(P< 0.05), but no significant difference was found between TLH group and TVH group(P>0.05). In terms of the ovarian function at 6 months after surgery, the levels of estradiol(E_2) and follicle-stimulating hormone(FSH) in the TLH group was different from those of TAH group, with statistically significant differences(P<0.05). Conclusions Laparoscopic hysterectomy has a relatively small effect on ovarian endocrine function, which can promote the recovery of sexual function.
Objective To explore the effect of different total hysterectomy on the sexual function and ovarian function of patients. Methods 90 patients received total hysterectomy in our hospital from March 2015 to March 2017 were selected, and according to the different methods of surgery, were divided into total laparoscopic hysterectomy group(TLH group, 30 cases), transvaginal hysterectomy group(TVH group, 30 cases) andtransabdominal hysterectomy group(TAH group, 30 cases). Surgery related indicators, postoperative sexual function and ovarian function was comprehensively evaluated before and after operation. Results The operation time and intraoperative blood loss in the TLH group was shorter and less than that in the TAH group, with statistically significant difference(P< 0.05). The postoperative sexual function in the TLH group and TVH group was significantly better than that in the TAH group, with statistically signifincat difference(P< 0.05), but no significant difference was found between TLH group and TVH group(P>0.05). In terms of the ovarian function at 6 months after surgery, the levels of estradiol(E_2) and follicle-stimulating hormone(FSH) in the TLH group was different from those of TAH group, with statistically significant differences(P<0.05). Conclusions Laparoscopic hysterectomy has a relatively small effect on ovarian endocrine function, which can promote the recovery of sexual function.
引文
[1] 谢秋娴,杨纯,谢昭雄,等.腹腔镜子宫肌瘤剥除术和腹腔镜次全子宫切除术对患者卵巢功能及其性功能的影响[J].中国性科学,2015,24(4):3-5.
[2] 刘福生,呼君瑜,秦杰,等.子宫动脉栓塞术与子宫全切术对子宫肌瘤患者卵巢功能的影响比较[J].河北医药,2014,23(17):2663-2664.
[3] 任小霞,汤晓秋,王艳君.不同手术方式子宫切除术对患者生殖系统及性功能的影响.陕西医学杂志,2016,45(10):1294-1296.
[4] Yoon A,Lee YY,Park W,et al.Correlation between location of transposed ovary and function in cervical cancer patients who underwent radical hysterectomy[J].International Journal of Gynecological Cancer,2015,25(4):688-689.
[5] 韩雪,金玲,孙鸿.不同方式子宫切除术治疗子宫肌瘤的疗效对比及对性功能的影响[J].中国性科学,2017,26(9):68-70.
[6] 李元宏,王齐尔,白静雯,等.腔镜全子宫与次全子宫切除术对患者卵巢及其性功能的影响[J].西部医学,2016,28(5):684-686.
[7] 林笑丹,林以堂,朱勇.子宫肌瘤不同术式对绝经过渡期女性患者卵巢功能、性功能及生活质量的影响[J].中国性科学,2014,23(10):3-5.
[8] 朱琴,陈丹.子宫肌瘤患者不同腹腔镜手术方式子宫切除的疗效、卵巢功能及患者性功能状况的临床研究[J].中国性科学,2017,26(8):42-45.
[9] 王红.腹腔镜全子宫切除术和腹腔镜次全子宫切除术对患者卵巢功能及其性功能的影响[J].中国计划生育和妇产科,2016,8(5):58-61.
[10] Sandberg EM,Twijnstra AR,Driessen SR,et al.Total laparoscopic hysterectomy versus vaginal hysterectomy:A systematic review and meta-analysis.[J].J Minim Invasive Gynecol,2017,24(2):206-217.
[11] 杨卫荔.腹腔镜全子宫切除术与腹腔镜次全子宫切除术对子宫肌瘤患者卵巢功能的影响[J].河南医学研究,2016,25(10):1864-1865.
[12] 段丽红.腹腔镜与开腹子宫切除术的疗效比较及对卵巢功能影响的研究[J].中外女性健康研究,2015,12(10):207.
[13] 和晓利,王悦,靖爽,等.腹腔镜辅助阴式子宫切除术与腹腔镜全子宫切除术临床效果比较[J].中华实用诊断与治疗志,2017,31(11):1095-1097.
[14] 王丹,王薇,裴丽杨,等.探讨次全子宫切除术治疗子宫肌瘤对女性卵巢功能的影响[J].中国实用医药,2016,11(30):117-118.
[15] 刘卫民,鲍友娥.3种子宫切除术式对育龄期宫颈癌患者性生活质量及卵巢功能的影响[J].中国性科学,2018,27(4):57-60.
[16] 陈海英.两种不同次全子宫切除术对卵巢内分泌功能及血脂水平的影响[J].现代诊断与治疗,2015,12(17):3969-3970.
[17] 付翠敏.不同术式对子宫肌瘤患者术后卵巢功能的改变[J].实用妇科内分泌电子杂志,2015,2(6):72-73.
[18] 任翠云,南芳芳.不同手术方法对子宫肌瘤患者卵巢功能及性功能的影响[J].中国肿瘤临床与康复,2015,21(7):779-781.
[2] 刘福生,呼君瑜,秦杰,等.子宫动脉栓塞术与子宫全切术对子宫肌瘤患者卵巢功能的影响比较[J].河北医药,2014,23(17):2663-2664.
[3] 任小霞,汤晓秋,王艳君.不同手术方式子宫切除术对患者生殖系统及性功能的影响.陕西医学杂志,2016,45(10):1294-1296.
[4] Yoon A,Lee YY,Park W,et al.Correlation between location of transposed ovary and function in cervical cancer patients who underwent radical hysterectomy[J].International Journal of Gynecological Cancer,2015,25(4):688-689.
[5] 韩雪,金玲,孙鸿.不同方式子宫切除术治疗子宫肌瘤的疗效对比及对性功能的影响[J].中国性科学,2017,26(9):68-70.
[6] 李元宏,王齐尔,白静雯,等.腔镜全子宫与次全子宫切除术对患者卵巢及其性功能的影响[J].西部医学,2016,28(5):684-686.
[7] 林笑丹,林以堂,朱勇.子宫肌瘤不同术式对绝经过渡期女性患者卵巢功能、性功能及生活质量的影响[J].中国性科学,2014,23(10):3-5.
[8] 朱琴,陈丹.子宫肌瘤患者不同腹腔镜手术方式子宫切除的疗效、卵巢功能及患者性功能状况的临床研究[J].中国性科学,2017,26(8):42-45.
[9] 王红.腹腔镜全子宫切除术和腹腔镜次全子宫切除术对患者卵巢功能及其性功能的影响[J].中国计划生育和妇产科,2016,8(5):58-61.
[10] Sandberg EM,Twijnstra AR,Driessen SR,et al.Total laparoscopic hysterectomy versus vaginal hysterectomy:A systematic review and meta-analysis.[J].J Minim Invasive Gynecol,2017,24(2):206-217.
[11] 杨卫荔.腹腔镜全子宫切除术与腹腔镜次全子宫切除术对子宫肌瘤患者卵巢功能的影响[J].河南医学研究,2016,25(10):1864-1865.
[12] 段丽红.腹腔镜与开腹子宫切除术的疗效比较及对卵巢功能影响的研究[J].中外女性健康研究,2015,12(10):207.
[13] 和晓利,王悦,靖爽,等.腹腔镜辅助阴式子宫切除术与腹腔镜全子宫切除术临床效果比较[J].中华实用诊断与治疗志,2017,31(11):1095-1097.
[14] 王丹,王薇,裴丽杨,等.探讨次全子宫切除术治疗子宫肌瘤对女性卵巢功能的影响[J].中国实用医药,2016,11(30):117-118.
[15] 刘卫民,鲍友娥.3种子宫切除术式对育龄期宫颈癌患者性生活质量及卵巢功能的影响[J].中国性科学,2018,27(4):57-60.
[16] 陈海英.两种不同次全子宫切除术对卵巢内分泌功能及血脂水平的影响[J].现代诊断与治疗,2015,12(17):3969-3970.
[17] 付翠敏.不同术式对子宫肌瘤患者术后卵巢功能的改变[J].实用妇科内分泌电子杂志,2015,2(6):72-73.
[18] 任翠云,南芳芳.不同手术方法对子宫肌瘤患者卵巢功能及性功能的影响[J].中国肿瘤临床与康复,2015,21(7):779-781.