Department of Obstetrics and Gynecology, Yangpu Central Hospital, Shanghai, China.
J Minim Invasive Gynecol. 2010 Jan-Feb;17(1):47-52. doi: 10.1016/j.jmig.2009.10.001.
To assess the effect on ovarian reserve function after laparoscopic uterine artery occlusion (LUAO) compared with laparoscopic surgery supracervical hysterectomy (LSH) and laparoscopic myomectomy (LM).
Prospective cohort study (Canadian Task Force classification II-1).
Hospital with experience in gynecologic minimal access surgery.
Ninety patients with uterine myomas operated on from August through December 2007.
Ninety patients were divided into 3 groups of 30 patients each: the study group underwent LUAO and myomectomy (LUAO-M), control group 1 underwent LSH, and control group 2 underwent LM only.
Blood samples were collected before surgery and at 1, 3, and 6 months postoperatively. Concentrations of follicle-stimulating hormone (FSH), leuteinizing hormone (LH), and estradiol (EZ) were determined using an immunoassay, and serum inhibin B (INHB) concentration was evaluated using an enzyme-linked immunosorbent assay. No significant differences in preoperative hormone concentrations between the 3 groups were found (p>.05). In the LSH group, FSH, LH, and E2 concentrations were significantly increased, whereas the INHB concentration was significantly decreased at 1 month postoperatively (p<.05); after 3 months, only the INHB concentration was significantly decreased (p<.05). However, in the LOUA-M and LM groups, there were no significant differences between preoperative and postoperative hormone concentrations (p>.05). Serum concentrations of FSH, LH, and INHB in the LSH group were significantly different from those in the study group at 1 and 3 months postoperatively (p<.05); however, the differences in postoperative hormone concentrations between the study group and the LM group were not significant (p>.05).
At short-term follow-up, no significant effect on ovarian reserve in patients with myoma who underwent LUAO was found.
评估腹腔镜子宫动脉阻断术（LUAO）与腹腔镜子宫切除术（LSH）和腹腔镜子宫肌瘤切除术（LM）对卵巢储备功能的影响。
前瞻性队列研究（加拿大任务组分类 II-1）。
具有妇科微创外科经验的医院。
2007 年 8 月至 12 月期间接受子宫肌瘤手术的 90 名患者。
90 名患者分为 3 组，每组 30 名患者：研究组行 LUAO 和子宫肌瘤切除术（LUAO-M），对照组 1 行 LSH，对照组 2 仅行 LM。
手术前和手术后 1、3 和 6 个月采集血样。采用免疫测定法测定卵泡刺激素（FSH）、黄体生成素（LH）和雌二醇（EZ）浓度，采用酶联免疫吸附试验评估血清抑制素 B（INHB）浓度。3 组患者术前激素浓度无显著差异（p>.05）。在 LSH 组中，FSH、LH 和 E2 浓度显著升高，而 INHB 浓度在术后 1 个月显著降低（p<.05）；3 个月后，仅 INHB 浓度显著降低（p<.05）。然而，在 LOUA-M 和 LM 组中，术前和术后激素浓度无显著差异（p>.05）。LSH 组患者术后 1 个月和 3 个月 FSH、LH 和 INHB 血清浓度与研究组有显著差异（p<.05）；然而，研究组与 LM 组术后激素浓度差异无统计学意义（p>.05）。
短期随访发现，LUAO 对子宫肌瘤患者的卵巢储备功能无明显影响。
