Tuna Volkan, Alkiş Ismet, Safiye Akansu Saylik, Imamoglu Nilufer, Bayram Nebahat, Ali Ismet Tekirdag
Department of Obstetric and Gynecology, Nizip Government Hospital, Nizip, Turkey.
Aust N Z J Obstet Gynaecol. 2010 Apr;50(2):194-9. doi: 10.1111/j.1479-828X.2009.01120.x.
In this study, comparing four different parameters in women with surgical menopause because of ovariectomy in reproductive age and in women with natural menopause, the effect of withdrawal of ovarian hormones on both groups was investigated. The patient groups in this study were constituted of 100 women in reproductive age who had undergone total abdominal hysterectomy + bilateral salpingo-oophorectomy and 50 women with natural menopause referred to out-patient's clinic within the same period. The findings for four different parameters were recorded one day before the surgery and at 3rd month post-operatively in surgical menopause group and at the day of referral to outpatient clinic in natural menopause group. The parameters planned to be recorded were blood lipid profile, thrombotic system, arterial elasticity and psychosexual variations. Post-operative high-density lipoprotein level in surgical menopause group was found lower than that of natural menopause group (47.08 vs 52.44 mg/dL, P < 0.05). Post-operative very low density lipoprotein level in surgical menopause group was increased more than that in natural menopause group (27.74 vs 23.58 mg/dL, P < 0.05). An increase was observed in post-operative carotid artery Pulsality Index and Resistive Index levels of surgical menopause group compared with natural menopause group (1.44 vs 1.33, P < 0.001 and 0.73 vs 0.68, P < 0.001 respectively). In surgical menopause group, the differences between pre- and post-operative values of bleeding time (1.15 vs 1.24, P < 0.0001), clotting time (5.9 vs 6.08, P < 0.0001) and fibrinogen level (422 vs 395, P < 0.0001) were found statistically significant. While bleeding time and clotting time were increased post-operatively, fibrinogen level was decreased. A significant increase was observed in post-operative mean Kupperman Index levels of surgical menopause group compared with that of natural menopause group (23.89 vs 9.94, P < 0.001). It was concluded that the ovaries should be considered as important organs impacting women's quality of life with their hormones produced also in the period of menopause; that disadvantages of oophorectomy during hysterectomy should be considered and that an attempt to conserve ovaries during surgery except pre-cancerous events would benefit women.
在本研究中，比较了因卵巢切除术导致手术绝经的育龄女性和自然绝经女性的四个不同参数，研究了卵巢激素撤退对两组的影响。本研究中的患者组由100名接受了全腹子宫切除术+双侧输卵管卵巢切除术的育龄女性和同期转诊至门诊的50名自然绝经女性组成。在手术绝经组手术前一天和术后第3个月以及自然绝经组转诊至门诊当天记录四个不同参数的结果。计划记录的参数包括血脂谱、血栓形成系统、动脉弹性和心理性变化。发现手术绝经组术后高密度脂蛋白水平低于自然绝经组（47.08对52.44mg/dL，P<0.05）。手术绝经组术后极低密度脂蛋白水平的升高幅度大于自然绝经组（27.74对23.58mg/dL，P<0.05）。与自然绝经组相比，手术绝经组术后颈动脉搏动指数和阻力指数水平升高（分别为1.44对1.33，P<0.001和0.73对0.68，P<0.001）。在手术绝经组中，术前和术后出血时间（1.15对1.24，P<0.0001）、凝血时间（5.9对6.08，P<0.0001）和纤维蛋白原水平（422对395，P<0.0001）的差异具有统计学意义。术后出血时间和凝血时间增加，而纤维蛋白原水平降低。与自然绝经组相比，手术绝经组术后平均库珀曼指数水平显著升高（23.89对9.94，P<0.001）。得出的结论是，卵巢应被视为在绝经期间也通过其产生的激素影响女性生活质量的重要器官；应考虑子宫切除术中卵巢切除术的弊端，并且除癌前病变外，手术中尝试保留卵巢将使女性受益。
