Habelt K, Brosche T, Riedel H H
Frauenklinik Heinrich Braun Krankenhaus Zwickau Frauenklinik und Endoskopiezentrum des Carl-Thiem-Klinikums Cottbus.
Zentralbl Gynakol. 1996;118(4):206-12.
A total of 437 patients who had undergone hysterectomy in the department of Obstetrics and Gynaecology, Heinrich Braun Clinic, Zwickau, between 1982 and 1992 were asked about vegetative and psychological problems after the operation. All were under 42 years old and had at least one ovary left intact. In all, 245 women returned the questionnaires. After hysterectomy 26.1% reported ovarian failure and 36.7% did not observe typical menopausal symptoms. Symptoms were significantly more frequent in patients where ovary had been removed. It made no difference whether a vaginal or an abdominal incision had been made. Psychic problems were reported by 17.6% of the patients. Patients with ovarian failure had more negative symptoms. Postoperatively, 34 women received hormonal therapy, and 10 of them finished the therapy successfully. The rate of ovarian failure and psychic symptoms can be reduced by adequate information before and after hysterectomy. A decision to perform a hysterectomy should be made only if the operations is strictly indicated. Prophylactic oophorectomy should not be performed in patients under 50 years. Effective hormonal substitution is recommended for patients with menopausal symptoms.
1982年至1992年间，在茨维考海因里希·布劳恩诊所妇产科接受子宫切除术的437名患者被询问术后的植物神经和心理问题。所有患者年龄均在42岁以下，且至少保留了一侧完整卵巢。共有245名女性回复了问卷。子宫切除术后，26.1%的患者报告出现卵巢功能衰竭，36.7%的患者未观察到典型的更年期症状。卵巢切除患者的症状明显更频繁。采用阴道切口还是腹部切口并无差异。17.6%的患者报告有心理问题。卵巢功能衰竭的患者有更多负面症状。术后，34名女性接受了激素治疗，其中10名成功完成治疗。子宫切除术前和术后提供充分信息可降低卵巢功能衰竭和心理症状的发生率。只有在严格指征的情况下才应决定进行子宫切除术。50岁以下患者不应进行预防性卵巢切除术。建议对有更年期症状的患者进行有效的激素替代治疗。
