不同止血方法处理卵巢手术创面的实验观察

An experimental observation on the ovarian after different surgical hemostatic procedures in rabbits

目的探讨不同止血方法对卵巢的影响。方法采用电凝、缝合、套扎三种处理兔卵巢手术创面。结果电凝组术后平均体积较术前降低(P<0.01),粘连分数低于缝合组和套扎组(P<0.01);缝合组术后平均体积与术前相比无统计学差异(P>0.05);套扎组术后平均体积亦较术前降低(P<0.05)。三组手术创面受损面积比较无统计学差异;缝合、套扎组光镜下主要为肉芽组织增生,而电凝组则表现为组织细胞的片状坏死。结论电凝能减少卵巢体积,从而可能影响卵巢功能;手术应尽可能采用缝合止血法,但应使用防粘连剂,预防术后粘连的发生。

Objective To observe the pathological changes of the ovarian after different surgical hemostatic procedures in rabbits. Methods Eighteen New Zealand white rabbits were randomly assigned to three groups according to hemostatic procedures of bipolar electrocautery （group A）, surgical suture （group B） and cish-endo-loop technique（group C）. Results The size of the ovanian in group A was decreased after hemostasis with bipolar electrocautery compaered with that before （P〈 0. 01）. The adhesion scoers of group A were lower than those of group B and C （P〈0. 01）. The size of the ovanian in group B was not changed significantly after surgery （P〉0.05）. The size of the ovanian in group C was decreased after hemostasis with cish endo-loop technique compaered with that before （P〈0. 05）. There wes no significant difference in traumatic area of the ovarian after three surgical hemostatic procedures. Tissue necrosis was seen in group A and granulation tissues in groups B and C. Conclusion Bipolar electrocautery can decrease ovarian volume, which may impair the ovarian function. Hemostasis by surgical suture with resorbable hydrogel is advocated.