既往输卵管结扎术会成为因子宫异常出血而行子宫切除术的危险因素吗？
Is Previous Tubal Ligation a Risk Factor for Hysterectomy because of Abnormal Uterine Bleeding?
作者信息
Moradan Sanam, Gorbani Raheb
机构信息
Department of Obstetrics and Gynecology, Amir Hospital, Semnan University of Medical Sciences, Semnan, Iran.
出版信息
Oman Med J. 2012 Jul;27(4):326-8. doi: 10.5001/omj.2012.81.
OBJECTIVES
Post tubal ligation syndrome (PTLS) is a term used to describe a variety of post tubal ligation side effects or symptoms. These include increased menstrual bleeding and hysterectomy. Whether or not post tubal syndrome is a real entity, it has been a subject of controversy in the medical literature for decades. Numerous studies have reported conflicting conclusions about these symptoms. In this study the incidence of hysterectomy for bleeding disorders among sterilized women was compared with the incidence of hysterectomy for bleeding disorders among non-sterilized female population of the same age.
METHODS
This study was carried out on 160 women, 38-52 years, who underwent hysterectomy in Amir University Hospital, Semnan, Iran, from September 2008 to September 2011. After gathering of data from medical records, in this study, the incidence of hysterectomy for bleeding disorders among sterilized women was compared with the incidence of hysterectomy for bleeding disorders among nonsterilized female population for the same age.
RESULTS
The mean age of the study group was 44/4±5/7 and the mean age of the control group was 45/2±5/3, (p=0.424).The mean parity of the study group was 3/8±1/8 and the mean parity of the control group was 3/5±1/4, (p=0.220). So, in regard to age and parity, two groups were matched. Hysterectomies were performed for 160 cases and abnormal uterine bleeding was the cause of hysterectomy in 67 cases. Among 67 cases, 19 cases (37.3%) had previous tubal sterilization + hysterectomy (study group) and 48 cases (44%) were not undergoing tubal sterilization but had hysterectomy for abnormal bleeding causes (control group). Statistical analyses showed that there were not significant differences between two groups, (RR=0.85; 95% CI: 0.56-1.28; p=0.418).
CONCLUSION
The result of this study showed that previous tubal sterilization is not a risk factor for undergoing hysterectomy because of abnormal uterine bleeding.
目的
输卵管结扎术后综合征（PTLS）是一个用于描述输卵管结扎术后各种副作用或症状的术语。这些包括月经量增多和子宫切除术。无论输卵管结扎术后综合征是否是一种真实的病症，几十年来它一直是医学文献中争论的主题。许多研究报告了关于这些症状的相互矛盾的结论。在本研究中，将绝育女性中因出血性疾病行子宫切除术的发生率与同年龄未绝育女性人群中因出血性疾病行子宫切除术的发生率进行了比较。
方法
本研究对2008年9月至2011年9月在伊朗塞姆南阿米尔大学医院接受子宫切除术的160名年龄在38 - 52岁的女性进行。从病历中收集数据后，在本研究中，将绝育女性中因出血性疾病行子宫切除术的发生率与同年龄未绝育女性人群中因出血性疾病行子宫切除术的发生率进行了比较。
结果
研究组的平均年龄为44.4±5.7岁，对照组的平均年龄为45.2±5.3岁，（p = 0.424）。研究组的平均产次为3.8±1.8，对照组的平均产次为3.5±1.4，（p = 0.220）。因此，在年龄和产次方面，两组是匹配的。共进行了160例子宫切除术，其中67例子宫切除术的原因是异常子宫出血。在这67例中，19例（37.3%）曾接受输卵管绝育 + 子宫切除术（研究组），48例（44%）未接受输卵管绝育但因异常出血原因接受了子宫切除术（对照组）。统计分析表明两组之间无显著差异，（相对危险度 = 0.85；95%可信区间：0.56 - 1.28；p = 0.418）。
结论
本研究结果表明，既往输卵管绝育不是因异常子宫出血而行子宫切除术的危险因素。
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