Abstract：Objective To analyze the influencing factors of perimenopausal symptoms after laparoscopic hysterectomy for benign uterine lesions. Methods A retrospective analysis was performed on the clinical data of 79 benign uterine lesions patients who underwent laparoscopic total hysterectomy in Changzhou Second People’s Hospital Affiliated to Nanjing Medical University from March 2018 to March 2020. The levels of sex hormones were measured before operation, one month after operation, and one year after operation, the modified Kupperman score scale was used to assess perimenopausal symptoms, the incidence of perimenopausal symptoms in patients with benign lesions undergoing laparoscopic total hysterectomy for one year after operation was counted, the influencing factors of perimenopausal symptoms in patients with benign lesions undergoing laparoscopic total hysterectomy were analyzed. Results A total of 79 patients were followed up for one year, and one patient was lost, which was not included in the statistics. One year after operation, the levels of estradiol, progesterone, and testosterone in patients with benign lesions undergoing laparoscopic total hysterectomy were lower than those of one month after operation and before operation, the levels of follicle stimulating hormone and luteinizing hormone were higher than those of one month after operation and before operation, and the differences were statistically significant (P < 0.05); one month after operation, the levels of estradiol, progesterone, and testosterone in patients with benign lesions undergoing laparoscopic total hysterectomy were lower than those before operation, the levels of follicle stimulating hormone and luteinizing hormone were higher than those before operation, and the difference were statistically significant (P < 0.05). One year after operation, perimenopausal symptoms occurred in 31 patients, and the incidence rate was 39.74%. Menopause and the levels of estradiol, progesterone, follicle stimulating hormone, luteinizing hormone, and testosterone were significantly different in patients with and without perimenopausal symptoms of one month after operation (P < 0.05). Menopause and the levels of estradiol, progesterone, and testosterone were independent risk factors for perimenopausal symptoms patients with benign lesions undergoing laparoscopic total hysterectomy (OR > 1, P < 0.05). Conclusion The levels of serum estradiol, progesterone, and testosterone are abnormally decreased, and the levels of follicle stimulating hormone and luteinizing hormone are abnormally increased in patients with benign lesions undergoing laparoscopic total hysterectomy, moreover, such patients are prone to perimenopausal symptoms. serum estradiol, testosterone, and progesterone levels are independent risk factors for perimenopausal symptoms in patients with benign lesions undergoing laparoscopic total hysterectomy.
[1] Mallinger WD，Quick CM. Benign and Premalignant Lesions of the Endometrium [J]. Surg Pathol Clin，2019，12（2）：315-328.
[2] 戚田进，孙彦玲.腹腔镜辅助下阴式子宫全切术治疗子宫良性病变的临床效果评价[J].中国计划生育和妇产科，2019，11（2）：81-84.
[3] 陈晓芹.腹式与困难阴式全子宫切除术对子宫良性病变患者的影响对比[J].中国妇幼健康研究，2017，28（11）：156-158.
[4] Uccella S，Malzoni M，Cromi A，et al. Laparoscopic vs transvaginal cuff closure after total laparoscopic hysterectomy：a randomized trial by the Italian Society of Gynecologic Endoscopy [J]. Am J Obstet Gynecol，2018，218（5）：501-513.
[5] 邓雅珑，黄荷凤，刘欣梅，等.腹腔镜下全子宫切除术并发泌尿道损伤的相关因素分析[J].中国计划生育和妇产科，2020，12（2）：74-77.
[6] 张弛远，高山，陈英汉，等.改良腹腔镜全子宫切除术的临床应用[J].中国微创外科杂志，2019，19（4）：311-313， 321.
[7] Dojki SS，Bano A. Outcome of Total Laparoscopic Hysterectomy [J]. J Coll Physicians Surg Pak，2018，28（6）：427-430.
[8] 黄灵霞，武静.不同子宫全切术式对卵巢功能影响[J].中国计划生育学杂志，2019，27（3）：379-381.
[9] Kossa?觙 M，Penault-Llorca F. Role of Hormones in Common Benign Uterine Lesions：Endometrial Polyps，Leiomyomas，and Adenomyosis [J]. Adv Exp Med Biol，2020，12（42）：37-58.
[10] 李家荣，章建梅，丁幼华，等.更年期妇女血清雌二醇与胰岛素抵抗和卵巢功能衰退的关系研究[J].中国妇幼保健，2019，34（11）：2543-2546.
[11] 华特斯，巴博，李叶，等.全子宫切除术：良性疾病手术方法[M].北京：人民军医出版社，2012：105-108.
[12] 路桃影，李艳，夏萍，等.匹兹堡睡眠质量指数的信度及效度分析[J].重庆医学，2014，43（3）：260-263.
[13] 雷磊.围绝经期综合征[M].长沙：湖南科学技术出版社，2011：108-111.
[14] Kohler C，Hertel H，Herrmann J，et al. Laparoscopic radical hysterectomy with transvaginal closure of vaginal cuff-a multicenter analysis [J]. Int J Gynecol Cancer，2019，29（5）：845-850.
[15] 刘灵霞，陈琼，何莎.腹腔镜辅助阴式全子宫切除术治疗巨大子宫肌瘤的效果观察[J].中国性科学，2019，28（1）：84-86.
[16] 吉颖莉，乔艳妮，田玉玉，等.腹腔镜辅助下阴式全子宫切除术治疗巨大子宫肌瘤128例分析[J].中国性科学，2018，27（4）：101-103.
[17] Baltisser I. Cytological findings in glandular lesions of the uterine cervix [J]. Pathologe，2020，41（2）：155-158.
[18] Cianci S，Gueli Alletti S，Rumolo V，et al. Total laparoscopic hysterectomy for enlarged uteri：factors associated with the rate of conversion to open surgery [J]. J Obstet Gynaecol，2019，39（6）：805-810.
[19] Abdel Khalek Y，Bitar R，Christoforou C，et al. Uterine manipulator in total laparoscopic hysterectomy：safety and usefulness [J]. Updates Surg，2020，72（4）：1247-1254.
[20] 姚伟妍，唐娟，方芙蓉，等.不同子宫切除术对于患者性激素分泌水平，围绝经期症状以及性功能的影响观察[J].中国妇幼保健，2019，34（2）：307-311.
[21] Wijk L，Ljungqvist O，Nilsson K. Female sex hormones in relation to insulin resistance after hysterectomy：A pilot study [J]. Clin Nutr，2019，38（6）：2721-2726.
[22] 张晨虹，林惠英，魏若菡.不同激素替代治疗对围绝经期综合征妇女的效果比较[J].中国妇幼健康研究，2019， 30（6）：82-85.
[23] Bromberger JT，Epperson CN. Depression During and After the Perimenopause：Impact of Hormones，Genetics，and Environmental Determinants of Disease [J]. Obstet Gynecol Clin North Am，2018，45（4）：663-678.
[24] Geiger PJ，Eisenlohr-Moul T，Gordon JL，et al. Effects of perimenopausal transdermal estradiol on self-reported sleep，independent of its effect on vasomotor symptom bother and depressive symptoms [J]. Menopause，2019， 26（11）：1318-1323.
[25] 汪丹，张晓静，刘琳.围绝经期激素治疗对内分泌代谢的影响[J].中国妇幼保健，2020，35（9）：131-134.
[26] 陈芳.不同剂量雌激素联合天然孕酮或地屈孕酮治疗围绝经期综合征的疗效观察[J].中国妇幼保健，2018，33（14）：126-128.
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