腹腔镜良性卵巢囊肿剔除术使用超声刀及单、双极电凝对卵巢功能的近期影响

A study of the influence on the ovarian function after laparoscopic ovarian surgery using the ultrasonic scalpel the monopolar and bipolar electrocoagulation

目的:研究腹腔镜良性卵巢囊肿剔除术使用超声刀及单、双极电凝对卵巢功能的近期影响。方法:单侧卵巢囊肿拟行囊肿剔除术116例患者,随机分为对照开腹组、超声刀组、单极电凝组、双极电凝组。所有患者分别于术前、术后1月、术后3月抽血测定E2、P、T、FSH、LH的水平,并进行术后随访。结果:四组病例在术后1月均出现E2下降及FSH、LH增高,分别与术前比较差异有显著意义(P<0.05),但4组之间FSH、LH、E2比较无差异(P>0.05)。术后3月各种激素水平与术前及术后1月比较无显著差异(P>0.05)。术后三个月以单极电凝组和对照开腹组导致月经异常的较其它组例数多,但4组间比较无显著差异(P>0.05)。结论:腹腔镜手术使用超声刀、单极及双极电凝不加重卵巢近期功能的损害。

Objective：To study the influence on the ovarian function after laparoscopic ovarian surgery using the ultrasonic scalpel the monopolar and bipolar electrocoagulation respectively. Methods： 116 patients with unilateral ovarian cysl were randomly assigned to four surgical groups. The controlled group underwent laparotomy. While the other groups underwent laparoscopic ovarian cystectomy by the ultrasonic scalpel, nnipolar and bipolar electrocoagulation. The levels of FSH ,LH ,E2 ,P,T were detected respectively before the operations and at 1m,3m after the operations. All patients were followed up for 3m. Results： At 1m postoperatively, the levels of E2 declined and that of FSH,LH increased in all groups, compared with those before operations respectively, and these differences were statistically significant（ P 〈0.05） , hut there was no difference among four groups （P 〉0.05 ）. The postoperative hormone level at 3m has no difference compared with those before the operations（ P 〉0.05 ）. The controlled group and the monopolar group had more menstruation abnormality, however, the ratio has no difference among all groups（ P 〉0.05 ）. Conclusions： Using the ultrasonic scalpel, the monopolar and bipolar electrocoagulation in laparoscopic surgery do not aggravate the damage of the recent ovarian function.