Page 104 - 南京医科大学自然科学版第1期

南京医科大学学报（自然科学版） 第41卷第1期
· 98 · Journal of Nanjing Medical University（Natural Sciences） 2021年1月

·临床研究·

育龄女性全子宫切除对认知影响的回顾性研究

王 艳 ，汤丽丽 ，史 曼 ，任慕兰 ，沈 杨 1*
1
1
3
2
1 东南大学附属中大医院妇产科，江苏 南京 210009；南京市江宁医院妇产科，江苏 南京 211100；东南大学医学院，江
2
3
苏 南京 210009
［摘 要］ 目的：探讨育龄女性全子宫切除对认知功能的影响。方法：收集2007年1月—2016年12月东南大学附属中大医院
妇科因子宫非恶性疾病行全子宫切除的未绝经女性患者，设为全子宫切除组；同期行单纯子宫肌瘤剔除的患者设为对照组。
匹配相关因素后，纳入全子宫切除组296例，对照组305例。2017—2018年随访1次，进行认知功能评估［简易智能精神状态量
表（mini⁃mental state examination，MMSE）及蒙特利尔认知评估量表（Montreal cognitive assessment，MoCA）］和绝经相关症状评估
［改良 Kupperman 绝经指数（Kupperman menopausal index，KMI）］。结果：MMSE 评分显示，全子宫切除组有 3 例存在认知功能
障碍，对照组未发现，差异无统计学意义（P=0.119）；MoCA评分显示，全子宫切除组有7例、对照组有1例存在认知功能障碍，差
异存在统计学意义（P=0.035）。在认知功能正常者中，全子宫切除组的认知错误发生率高于对照组（P < 0.05）。KMI 评分显
示，全子宫切除组绝经症状的发生率显著高于对照组，差异有统计学意义（P＜0.001）。结论：育龄期行全子宫切除的女性远期
存在认知功能下降，可能与卵巢功能下降有关。
［关键词］ 认知功能；全子宫切除；育龄期；绝经
［中图分类号］ R713.4 ［文献标志码］ A ［文章编号］ 1007⁃4368（2021）01⁃098⁃05
doi：10.7655/NYDXBNS20210118

A retrospective study on the impact of total hysterectomy on cognition in women of

reproductive age
3
1
2
1
WANG Yan ，TANG Lili ，SHI Man ，REN Mulan ，SHEN Yang 1*
Department of Obstetrics and Gynecology，Zhongda Hospital，Southeast University，Nanjing 210009；Department of
1 2
Obstetrics and Gynecology，Nanjing Jiangning Hospital，Nanjing 211100；School of Medicine，Southeast University，
3
Nanjing 210009，China
［Abstract］ Objective：To investigate the impact of total hysterectomy on cognitive function in women of reproductive age. Methods：
Premenopausal women who underwent total hysterectomy for non ⁃ malignant diseases from January 2007 to December 2016 in the
Department of Gynecology，Zhongda Hospital Southeast University were collected as the total hysterectomy group（n=296），while
subjects who underwent myomectomy at the same time were collected as control group（n=305）. One follow⁃up questionnaire survey
including mini⁃mental state examination（MMSE），Montreal cognitive assessment（MoCA）and Kupperman menopause index（KMI）was
conducted from 2017 to 2018. Results：MMSE score showed that 3 subjects in the total hysterectomy group were found cognitive
dysfunction，while no subject was found cognitive dysfunction in the control group. The difference was not statistically significant（P=
0.119）. MoCA score showed that 7 subjects in the total hysterectomy group and 1 subject in the control group were found cognitive
dysfunction during follow⁃up，and the difference was statistically significant（P=0.035）. Among those women with normal cognitive
function，the incidence of cognitive errors in the total hysterectomy group was higher than that in the control group（P < 0.05）. KMI
score showed that the incidence of menopausal symptoms in the total hysterectomy group was significantly higher than that in the
control group（P < 0.001）. Conclusion：Cognitive function declines in long⁃term period in women of reproductive age who undergo
total hysterectomy，which may be related to ovarian function decline.
［Key words］ cognitive function；total hysterectomy；reproductive age；menopause
［J Nanjing Med Univ，2021，41（01）：098⁃102］
［基金项目］ 江苏省妇幼健康科研项目（F201665）；江苏省研究生科研与实践创新计划项目（SJCX17_0064）；南京市医学科技
发展一般性课题（YKK16284）
∗
通信作者（Corresponding author），E⁃mail：shenyang0924@sina.cn