2012年中考时间
carb
当代医学2020年8月第26卷第22期总第573期Contemporary Medicine ，Aug.2020，Vol.26No.22Issue No.573
doi：10.3969/j.issn.1009-4393.2020.22.024--论著--
保留血管的部分子宫切除术对卵巢功能影响的
临床研究
韩玉英，王庆一，郑嘉尧
life is so cool（珠海市中西医结合医院妇科，广东珠海519000）
摘要：目的探讨保留血管的部分子宫切除术对卵巢功能保护的临床价值。方法选取2016年7月至2019年1月于本院妇科治疗的子宫腺肌症患者160例，根据手术方式不同分为实验组和对照组，每组80例。实验
组行腹腔镜下保留血管的部分子宫切除术，对照组行腹腔镜次全子宫切除术。比较两组患者手术时间、术中出血量、术后排气时间及住院时间；术后3个月及6个月血清E 2、FSH、LH 水平；术后绝经综合征
发生率。结果两组患者手术时间、术中出血量、术后排气时间及住院时间比较差异无统计学意义；术后3、6个月，实验组血清E 2、FSH、LH 水平均较为平稳，与术前比较差异无统计学意义；术后3、6个月，对照组血清FSH 和LH 水平明显升高，E 2明显降低（P ＜0.05）。实验组绝经综合征
发生率为6.3%，明显低于对照组的21.3%（P ＜0.05）。结论保留血管部分子宫切除术能保留部分子宫体及子宫动脉上行支，在术后缝合成一个小子宫，维持盆腔器官的完整性及卵巢的正常血供，延缓卵巢功能的衰退，避免术后卵巢功能减退而出现的绝经综合征。
关键词：保留血管部分子宫切除术；次全子宫切除术；绝经综合征；卵巢功能
A clinical study on the effect of partial vascularized
hysterectomy on ovarian function
circletHan Yuying,Wang Qingyi,Zheng Jiayao
shapeup
boer(Department of Gynaecology,Zhuhai Integrated Traditional Chine and Western Medicine Hospital,
Zhuhai,Guangdong,519000,China)
Abstract:Objective To explore the clinical value of partial hysterectomy with blood vesl prervation for the protection of ovarian function 。Methods 160patients with adenomyosis treated in gynecology in our hospital from July 2016to January 2019were lected and divided into ex-perimental group and control group according to different surgical methods,with 80cas in each group.The experimental group underwent laparo-scopic partial hysterectomy with prerved blood vesls,and the control group underwent laparoscopic subtotal hysterectomy.Compare the opera-tion time,intraoperative blood loss,postoperative exhaust time and hospitalization time between the two groups,compared the rum E 2,FSH,LH levels at 3and 6months after surgery,compared the incidence of postoperative menopausal syndrome.Results There was no significant difference between the two groups of patients in operation time,intraoperative blood loss,postoperative exhaust time and hospital stay.At 3and 6months after surgery,the levels of rum E 2,FSH,and LH in the experimental group were relatively stable,and there was no statistically significant difference compar
ed with tho before surgery.At 3and 6months after surgery,the level of rum FSH and LH in the control group was significantly incread,E 2was significantly reduced (P ＜0.05).The incidence of menopausal syndrome in the experimental group was 6.3%,which was significantly lower than the 21.3%in the control group (P ＜0.05).Conclusion Part of the uterus body and ascending branches of the uterine artery were retained in the va-prerving partial hysterectomy,and a small uterus was sutured to maintain the integrity of pelvic organs and normal blood supply to the ovary,delaying the decline of ovarian function,and avoiding the menopau syndrome caud by the decline of ovarian function after surgery.四级官网准考证打印
Key words:Vascularized partial hysterectomy;Subtotal hysterectomy;Menopausal syndrome;Ovarian function
子宫腺肌症多发生于育龄期妇女，常合并子宫内膜异位症及子宫肌瘤，主要症状是月经量增多及继发性进行性痛经，手术为主要治疗方法。传统的手术为全子宫切除术或次全子宫切除术，传统的子宫切除术可减少卵巢的正常血液供应，且术后有发生残留卵巢综合征的风险。经临床证实，卵
巢的血液供应有约50%来自于子宫动脉的上行支[1]。有研究证实，保留子宫动脉上行支的子宫体大部分切除手术，未切断子宫动脉上行支，保留卵巢正常血供，显著保护双侧卵巢生理功能[2]。故珠海市
中西医结合医院妇科为保护年轻子宫腺肌症患者的卵巢功能，设计出腹腔镜部分子宫切除术，通过回顾性分析2016年7月至2019年1月于本院手术治疗的180例子宫腺肌症患者的临床资料，比较腹腔镜次全子宫切除术及腹腔镜保留血管的部分子宫切除术对患者术后内分泌及术后生活质量的影响，现报道如下。
1资料与方法
frogen
1.1临床资料选取珠海市中西医结合医院妇科2016年7月至2019年1月收治的30～45岁因子宫腺肌症而需手术治疗的非绝经期有次全子宫切除术（subtotal rection of uterus）指征的患者160例，根据手术方式不同分为保留血
——herbivore
512护士节演讲稿63
