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目的：探讨经腹和经阴道子宫切除术围术期糖代谢及相关激素的变化。方法：选 Ａ Ｓ Ａ Ⅰ～Ⅱ级全子宫切除患者１４ 例，分为经腹子宫切除组（ Ａ Ｈ 组） 和经阴道子宫切除组（ Ｖ Ｈ 组） ，两组分别于术前、术中、术后用酶法或放射免疫法测定血浆葡萄糖、乳酸、不饱和脂肪酸和胰岛素、胰高血糖素、皮质醇、儿茶酚胺。结果：两组术中、术后葡萄糖、游离脂肪酸均比术前显著增高（ Ｐ＜ ０ ．０５ ～ Ｐ＜ ０ ．０１） ，两组间血浆葡萄糖差异亦有显著性（ Ｐ＜ ０ ．０５） ； Ｖ Ｈ 组皮质醇增加明显（ Ｐ＜ ０ ．０５） ，儿茶酚胺在两组均明显增高（ Ｐ＜ ０ ．０５ ～ Ｐ＜ ０ ．０１） 。结论：经阴道子宫切除有显著的高血糖反应，对有糖尿病及糖耐量受损的患者有一定的临床意义。
Objective: To investigate the perioperative glucose metabolism and related hormones in transabdominal and transvaginal hysterectomy. Methods: A total of 14 patients underwent total hysterectomy of AS Ⅰ ~ Ⅱ were divided into abdominal hysterectomy group (A H group) and vaginal hysterectomy group (V H group) Postoperatively, plasma glucose, lactate, unsaturated fatty acids and insulin, glucagon, cortisol and catecholamines were determined by enzymatic or radioimmunoassay. Results: The intraoperative and postoperative glucose and free fatty acids in both groups were significantly higher than those before operation (P0.05 ~ P0.01). There was also significant difference in plasma glucose between the two groups (P0.05) (P <0.05). Catecholamines were significantly increased in both groups (P <0 .05 ~ P <0.01). CONCLUSION: Transvaginal hysterectomy has significant hyperglycemic response and has certain clinical significance for patients with diabetes and impaired glucose tolerance.