子宫及卵巢切除术对女性内分泌和性功能的影响

子宫与卵巢是女性性器官,具有多种内分泌功能,产生许多生物活性物质调节机体内分泌系统,二者保持平衡状态可使机体内分泌稳定,性功能正常。因良性疾病切除子宫后,卵巢血供受损,功能下降,可发生卵巢功能早衰,更年期症状提前出现;因病需要同时切除卵巢者,可使更年期症状加重,影响女性内分泌及性功能并可增加心血管系统疾病和骨质疏松症的发病率。因此建议在外科手术时应严格掌握子宫及卵巢切除的适应证,尽量减少不必要的损伤给女性带来的不良后果。     

子宫切除对患者身心健康的影响

子宫不但是重要的生殖器官，同时也被认为是一个内分泌器官。切除子宫虽是治疗子宫肌瘤的有效手段，但对患者的精神心理、性生活质量有无影响也是一个非常敏感的问题。本文将重点探讨子宫切除术对患者精神心理、性生活及内分泌的影响。     

腹腔镜全子宫切除术学习曲线探讨

为探讨腹腔镜下全子宫切除术学习曲线,收集我院自2011年6月至2012年6月由同一组医师连续开展最初50例腹腔镜下全子宫切除术病例,以每10例为一个手术阶段,分析记录其平均手术时间、出血量、并发症情况等.结果显示成功施行腹腔镜全子宫切除术50例,各组病例在年龄、BMI、既往有无腹部手术史等一般情况比较无明显差异.不同阶段术中出血量、手术时间比较差异有统计学意义(P＜0.05);进一步两两比较结果显示,第1阶段与第3、4、5阶段术中出血量比较差异有统计学意义,第2阶段与第3、4、5阶段术中出血量比较差异有统计学意义(P＜0.05),其余各阶段术中出血量无明显差异(P＞0.05).第1阶段与第2、3、4、5阶段手术时间比较差异有统计学意义(P＜0.05).其余各阶段手术时间比较无明显差异(P＞0.05).由此推断腹腔镜下全子宫切除术学习曲线大约为10例～20例,即可达到较熟练水平和稳定程度.     

保留子宫动脉筋膜内子宫切除术对卵巢功能的影响

为了探讨保留子宫动脉上行支筋膜内子宫切除术对卵巢功能的影响,将90例符合条件的患者,随机分成研究组（行保留子宫动脉上行支筋膜内子宫切除术）和对照组（行筋膜内子宫切除术）,重点观察两组手术对卵巢功能的影响。对照组血卵泡刺激素（FSH）、雌二醇（E2）术后与术前相比,差异有统计学意义（P＜0．05）。两组更年期症状的发生率差异有统计学意义（P＜0．05）。保留子宫动脉上行支筋膜内子宫切除术术后近期卵巢功能影响小,远期效果有待观察。     

诺舒阻抗与宫腔镜两种子宫内膜切除术的比较研究

探讨诺舒阻抗子宫内膜切除术在月经过多患者中的临床应用及优越性。将我院2010年1月至2014年5月行诺舒阻抗子宫内膜切除术的57例患者,纳为治疗组。同期宫腔镜单极子宫内膜切除术的45例患者,纳为对照组,比较两组患者术中情况及术后随访各项指标。发现治疗组的手术时间、术中出血量、膨宫液吸收量、电解质紊乱、术后阴道出血时间、阴道排液时间、宫腔积血、宫腔粘连、药物辅助治疗、再次手术（全子宫切除术）均低于对照组,组间对比有统计学意义（P〈0．05）。诺舒阻抗子宫内膜切除术具有学习曲线短、手术易掌握、操作安全、疗效肯定的优点,是目前子宫内膜切除术的首选方法。     

卵巢子宫内膜异位症囊肿剥除术与卵巢功能

子宫内膜异位症是女性慢性盆腔痛和不孕主要病因,好发部位为卵巢、腹膜与阴道直肠膈.腹腔镜检查手术是诊断和治疗卵巢子宫内膜异位症的金标准.年轻未育的患者术后出现卵巢早衰,是近年来出现的新问题.本研究通过文献调查,分析各种预防和治疗卵巢早衰的可行措施.     

卵巢子宫内膜异位症囊肿剥除术与卵巢功能

子宫内膜异位症是女性慢性盆腔痛和不孕主要病因,好发部位为卵巢、腹膜与阴道直肠膈。腹腔镜检查手术是诊断和治疗卵巢子宫内膜异位症的金标准。年轻未育的患者术后出现卵巢早衰,是近年来出现的新问题。本研究通过文献调查,分析各种预防和治疗卵巢早衰的可行措施。     

卵巢激素影响女性恐惧情绪加工的神经机制

大脑结构和功能的性别差异导致恐惧情绪加工的两性差别。女性对恐惧情绪加工受到体内雌激素和孕激素浓度的影响。近年来, 人类脑成像技术、遗传学和分子生物学的综合研究发现了卵巢激素影响女性恐惧情绪加工的神经机制。其中, 雌激素水平升高导致杏仁核活动增强, 使女性对恐惧面孔识别的准确性增加, 而孕激素水平则相反。这与女性在月经周期不同阶段对社会交往的需求和妊娠期间的自我保护机制有关。     

早期应激对抑郁相关行为及神经内分泌反应的长期影响

临床研究发现,早期创伤性经历是导致成年抑郁症易感性增加的高风险因素之一。但早期应激通过何种途径对抑郁发病产生长期的影响,目前尚不清楚。本文综述了近年来有关的实验动物研究,从早期应激的动物模型建立、早期应激对成年动物抑郁相关行为及神经内分泌反应的长期影响等方面进行了系统论述和分析,进而提出了早期应激并不影响动物的本能行为,但早期应激影响与行为动机和应激应对等认知相关的行为的观点,进一步论证了早期应激是通过增加个体潜在的易患病素质对抑郁症发病产生影响     

影响全子宫切除术施术途径选择的因素的初步分析

通过回顾分析（n=1238）和电话问卷调查（n=864），分析子宫切除术手术途径（开腹、腹腔镜、阴式）选择有关的因素，并探讨其在决策过程中的作用。结果发现，疾病本身的特点是影响手术途径选择的最主要因素。如果有备选途径，医师的偏好成为重要的抉择因素。患者在决策过程中的作用除受医师影响外，还受医疗费用支付方式制约。伤口美观和术后恢复快是腹腔镜子宫切除术患者选择该途径的主要原因。     

Sexual Contact During and After Professional Relationships: Practices and Attitudes of Female Counselors

A national sample of female counselors (N = 377) was surveyed regarding sexual contact in professional relationships. Few respondents reported engaging in sexual contact either during or following professional relationships with clients, supervisees, or students. Individuals with doctoral degrees were more likely to have engaged in sexual contact with their own counselors, supervisors, or teachers. Counselors viewed sexual contact in current professional relationships as less ethical than contact in subsequent relationships, although relationships with former clients were seen as less ethical than relationships with former supervisees or students. Compared with male counselors from a previous study, female counselors were less likely to report sexual contact in their professional roles. Implications for research and training are discussed.     

The Effect of Female Aggressiveness on Aggressive and Sexual Fantasies

Fifty-five fraternity and sorority members were made angry by a hostile female experimenter to investigate whether the sex of the anger-arousing individual has an effect on a connection between anger and sexuality found in earlier studies. Subjects wrote stories to two male-dominant (MD) and two female-dominant (FD) TAT pictures. Aroused groups responded to an aggressive arousal with increases in sexual motivation which replicates earlier findings. The results are discussed in terms of the cues presented by the experimenter and the possibility of two types of defensiveness: reduction of TAT imagery and increases in defensive scoring.     

Childhood Sexual Abuse and Female Spiritual Development

Religiously involved lay women (N = 266), 31% of whom had been sexually abused in childhood, filled out the revised Spiritual Experience Index (SEI-R). Results showed higher SEI-R scores for the sexually abused group, with a more accepting attitude compared with those with a striving attitude. A subscale of the SEI-R revealed that the sexually abused may turn to their faith and spirituality for support. Those with the highest educational achievements, Catholics, and those who experienced emotional abuse scored high on the Spiritual Openness subscale. Implications for spiritual development and counseling are discussed.     

Female Pornography Use and Sexual Coercion Perpetration

This study assesses the effect of low self-control on traditional offending-oriented outcomes and three imprudent behaviors—“drunk dialing,” public profanity, and public flatulence. The sample consists of approximately 500 undergraduate students. The results from the regression analyses show that low self-control is associated with typical offending, academic fraud, and binge drinking. More importantly, low self-control is also associated with making telephone calls while under the influence of alcohol, using offensive language in public places, and publicly expelling digestive gases. The results suggest that low self-control not only explains traditional offending-oriented outcomes, but also understudied forms of social deviance.     

Sex Role Orientation and Female Sexual Functioning

This study investigates the differences among women in four sex-role categories–Feminine, Masculine, Androgynous, and Undifferentiated–with regard to sexual behavior and attitudes. The sample consists of 300 undergraduate and graduate women enrolled in 27 classes during the spring of 1978. Four criterion instruments are used: (1) the Bern Sex Role Inventory , (2) the Sexual Arousability Inventory , (3) the Sexual Behavior Inventory, and (4) the Sexual Data Form. Eight null hypotheses are tested. A multivariate analysis of variance revealed significant differences (p ≦.05) on three of the eight comparisons. A post hoc analysis revealed the source of significance to be between Undifferentiated women and women in the other three sex-role categories on satisfaction with sexual responsivity and frequency of an orgasm with partner.     

Lower Sexual Satisfaction and Function Mediate the Association of Assault Military Sexual Trauma and Relationship Satisfaction in Partnered Female Service Members/Veterans

Little is known about the association of military sexual trauma (MST) and relationship satisfaction among partnered female service members/veterans (SM/Vs). Extant civilian literature shows a strong association between sexual trauma and poorer relationship outcomes, and theory suggests that sexual function and satisfaction may mediate this association. Given that as many as 40% of female SM/Vs report MST and roughly half of female veterans are partnered and in their peak sexual years, it is critical to understand the association of MST, relationship satisfaction, sexual function, and sexual satisfaction in this population. Female SM/Vs (N = 817) completed a demographic inventory, self-report measures of MST, relationship satisfaction, sexual function, and sexual satisfaction. One hundred fifty-one (18.48%) participants did not experience MST. Three hundred eighty-eight (47.49%) reported that they experienced harassment-only MST, and 278 (34.03%) reported assault MST. At the bivariate level, lower relationship satisfaction was associated with lower sexual function and satisfaction with large effect sizes. Assault MST was associated with lower relationship satisfaction and sexual function and satisfaction with small-to-medium effect sizes. No differences in relationship satisfaction, sexual satisfaction, and function between those with harassment-only and no MST were observed. Mediation analyses demonstrated that lower sexual function and satisfaction mediated the association of assault MST and relationship satisfaction. Couples’ therapy offered to SM/Vs with MST should screen for type of MST, sexual function, and satisfaction. Addressing the sequelae of MST and increasing sexual function and satisfaction in these partnerships may be critical treatment targets.     

The Satir Model with Female Adult Survivors of Childhood Sexual Abuse

Child sexual abuse is a recognized problem in the United States and Canada. There are several approaches to therapy with adult survivors of childhood sexual abuse. This article discusses Virginia Satir's model of therapy as it applies to sexual abuse. The emphasis of the Satir model is on transforming the impact of the abuse, no matter how the client chooses to process her relationship with the abuse, and is illustrated through a case study.