Nilas L, Loft A
Gynaekologisk-obstetrisk afdeling, Hvidovre Hospital, København.
Ugeskr Laeger. 1993 Nov 22;155(47):3818-22.
In Denmark, about 6000 hysterectomies are performed annually, and about 75% are performed on benign indications in women less than 50 years of age. When deciding on oophorectomia per occasionem, the risk of disease in the retained ovaries must be weighed against the advantages of continued ovarian function. The literature about ovarian function after hysterectomy consists predominantly of older, retrospective and uncontrolled investigations describing earlier menopause, increased frequency of climacteric symptoms and increased risk of benign ovarian cysts. Hysterectomy is followed by histological changes in the retained ovaries, but a significant reduction in the ovarian hormone production is not documented. Several studies have indicated that hysterectomy is followed by an increased risk of ischaemic heart disease, but the literature is equivocal. A possible explanation for the altered ovarian function after hysterectomy is reduced ovarian blood supply caused by the operation, but the existence of a direct endocrine function of the uterus can not be excluded. Solid prospective studies of the ovarian function following hysterectomy are needed.
在丹麦，每年约进行6000例子宫切除术，其中约75%是针对50岁以下女性的良性指征进行的。在决定适时进行卵巢切除术时，必须权衡保留卵巢中疾病的风险与卵巢功能持续存在的益处。关于子宫切除术后卵巢功能的文献主要由早期的回顾性和非对照研究组成，这些研究描述了更早进入更年期、更年期症状频率增加以及良性卵巢囊肿风险增加。子宫切除术后，保留的卵巢会出现组织学变化，但并未记录到卵巢激素分泌显著减少。几项研究表明，子宫切除术后缺血性心脏病的风险会增加，但文献对此尚无定论。子宫切除术后卵巢功能改变的一个可能解释是手术导致卵巢血液供应减少，但不能排除子宫存在直接内分泌功能的可能性。需要对子宫切除术后的卵巢功能进行可靠的前瞻性研究。
