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基于手术类型探讨子宫切除术对术后早期卵巢储备功能的影响。

Effect of Hysterectomy on Ovarian Reserve in the Early Postoperative Period Based on the Type of Surgery.

作者信息

Chun Sungwook, Ji Yong Il

机构信息

Department of Obstetrics and Gynecology, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.

出版信息

J Menopausal Med. 2020 Dec;26(3):159-164. doi: 10.6118/jmm.20010.

Abstract

OBJECTIVES

This study aimed to evaluate the influence of simple hysterectomy on the ovarian reserve based on the type of surgery.

METHODS

Eighty-six premenopausal women between 31 and 48 years who underwent hysterectomy for benign gynecologic disease without additional adnexal surgery at a university hospital participated in this study. Seventy-one patients underwent laparoscopy-assisted vaginal hysterectomy (LAVH), and 15 patients underwent abdominal hysterectomy (AH). Blood samples were obtained from all study participants on preoperative day and 3 days after the operation to determine the anti-Müllerian hormone (AMH) levels.

RESULTS

The postoperative reduction of the mean serum AMH level in the LAVH group (0.42 ± 0.76 ng/mL) was greater than that in the AH group, although the difference was not statistically significant (0.01 ± 0.60 ng/mL) ( = 0.053). The mean baseline AMH level (2.59 ± 2.33 ng/mL) was significantly reduced to 2.24 ± 2.08 ng/mL at 3 days after hysterectomy, and the mean rate of decline of AMH levels after surgery was 13.61% ± 30.81%. In subgroup analysis based on the type of surgery, the mean serum AMH level decreased significantly after surgery in the LAVH group, but no significant changes were found in serum AMH levels before and after the surgery in the AH group.

CONCLUSIONS

These preliminary results suggest that simple hysterectomy affects the early postoperative decline of ovarian reserve, and these results might vary depending on the type of surgery.

摘要

目的

本研究旨在根据手术类型评估单纯子宫切除术对卵巢储备功能的影响。

方法

86名年龄在31至48岁之间、因良性妇科疾病在大学医院接受子宫切除术且未进行额外附件手术的绝经前女性参与了本研究。71例患者接受了腹腔镜辅助阴道子宫切除术(LAVH),15例患者接受了腹式子宫切除术(AH)。在术前及术后3天采集所有研究参与者的血样,以测定抗苗勒管激素(AMH)水平。

结果

LAVH组术后平均血清AMH水平的降低幅度(0.42±0.76 ng/mL)大于AH组,尽管差异无统计学意义(0.01±0.60 ng/mL)(P = 0.053)。子宫切除术后3天,平均基线AMH水平(2.59±2.33 ng/mL)显著降至2.24±2.08 ng/mL,术后AMH水平的平均下降率为13.61%±30.81%。在基于手术类型的亚组分析中,LAVH组术后平均血清AMH水平显著下降,但AH组手术前后血清AMH水平未发现显著变化。

结论

这些初步结果表明,单纯子宫切除术会影响术后早期卵巢储备功能的下降,且这些结果可能因手术类型而异。

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