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1、子宫动脉栓塞和子宫切除术对卵巢功能的影响【摘要】目的探讨子宫动脉栓塞和子宫切除2种术式对子宫肌瘤患者卵巢功能的影响。方法78例子宫肌瘤患者随机分为子宫动脉栓塞术组(栓塞组)和子宫切除术组(切除组),术前、术后3个月、6个月、1年、2年用化学发光法测定患者血中生殖内分泌激素(FSH、LH、E2)水平,监测卵巢排卵功能，比较每组之间内分泌激素(FSH、LH、E2)水平的变化。结果术前栓塞组FSH、LH、E2水平与切除组比较，差异无统计学意义(P>0.05);切除组术后FSH、LH水平均较术前增高(P<0.01),
2、E2水平较术前降低(P<0.001);栓塞组术后FSH、LH及E2水平与术前比较，无明显变化(P>0.05)。结论子宫切除术对卵巢功能影响明显,子宫动脉栓塞对卵巢功能无明显影响。【关键词】子宫肌瘤;子宫切除术;子宫动脉栓塞术;卵巢功能TheinfluenceonovarianfunctionafterhysterectomyoruterinearteryembolizationFENGBibo,WANGXiping,ZHAIJianjun,etal.DepartmentofObstetricandGyneco
3、logy,BeijingTongrenHospitalAffiliatedtoCapitalMedicalUniversity,Beijing100730,China【Abstract】ObjectiveToinvestigatetheovarianfunctionofpatientswithuterineleiomyomaafterhysterectomyoruterinearteryembolization(UAE).MethodsAtotalof78patientswithuterineleiomyom
4、awereenrolledandrandomlydividedintouterinearteryembolizationgroupandhysterectomygroup.Theserumconcentrationsofestrogen(E2),follicularstimulatinghormone(FSH),luteinizinghormone(LH)weremeasuredbeforetreatmentand3,6,12and24monthsaftertreatment.Simultaneously,o
5、vulatingfunctionsofovaryweremonitored.Allresultswerecomparedbetweengroups.ResultsTherewerenosignificantdifferencesbetweentwogroupsinthelevelsofFSH,LHandE2beforetreatment(P>0.05).Forthehysterectomygroup,theserumconcentrationofE2wassignificantlylowerandtheser
6、umconcentrationsofFSHandLHweresignificantlyhigherthanthosebeforetreatment(bothP<0.01).NosignificantdifferencewasfoundinthelevelsofFSH,LHandE2betweenpre-UAEandpost-UAE.Ovulatingfunctionresumedearlieraftertherapy.ConclusionsHysterectomymayhaveaneffectonthefun
7、ctionofovary,whileuterinearterialembolizationmaynotaffectovarianfunctionofpatientswithuterineleiomyoma.【Keywords】Uterineleiomyoma;Hysterectomy;Uterinearterialembolization;ovarianfunction子宫肌瘤为女性生殖系统最常见的良性肿瘤,发生率约20%～25%[1],主要表现为月经量增多、痛经及邻近器官的压迫症状，如尿频、便秘等。目前临床
8、治疗方法有子宫切除术、肌瘤摘除术以及药物保守治疗。子宫肌瘤保守治疗尤其是子宫动脉栓塞术(uterinearterialembolization,UAE)在减少肌瘤大小、控制临床症状方面已取得显著疗效，然而仍有许多争议，尤其对卵巢功能的影响[2,3]。本研究通过对2组子宫肌瘤患者行子宫切除或动脉栓塞术后卵巢功能影响的前瞻性研究，以探讨2种术式对卵巢功能的影响。对象与方法一、对象选择2002年9月至20
