腹腔镜下卵巢良性肿瘤剥出术对卵巢储备功能的影响研究

Study on effect of laparoscopic benign ovarian carcinoma enucleation on ovarian reserve function

目的:探讨腹腔镜下卵巢肿瘤剥除术后对卵巢储备功能的影响。方法:对比分析腹腔镜下单侧62例、双侧19例共81例良性卵巢肿瘤剥除术后患者3个月的临床表现及血清E2、FSH、LH水平的变化,并行阴道B超检测卵巢情况。结果:单侧剥除者术后FSH、LH较术前比较差异无统计学意义;双侧剥除者术后FSH、LH较术前及单侧剥除者均升高,差异有统计学意义(P<0.05),而E2虽有所降低,但与术前比较差异无统计学意义。阴道B超检测提示卵巢肿瘤剥除后卵巢的基质血流指数RI、S/D、PI无明显改变,但卵巢体积及窦卵泡数明显减少,差异有统计学意义。结论:双侧卵巢肿瘤剥除术较单侧卵巢肿瘤剥除术对卵巢功能的影响较大,且卵巢肿瘤剥除术后对卵巢的储备功能有一定影响,手术中应尽量保护卵巢的储备功能。

Objective： To explore the effect of laparoscopic benign ovarian carcinoma enucleation on ovarian reserve function. Methods： The clinical manifestations and the changes of serum estrogen, follicle stimulating hormone （FSH） and luteinizing hormone （LH） levels of 81 cases with benign ovarian carcinoma （62 cases of single side and 19 cases of double side） were compared and analyzed on the third month after laparoscopic benign ovarian enucleation, then vaginal B -ultrasound was performed to detect ovarian conditions. Results： In patients with unilateral benign ovarian carcinoma, there was no significant in levels of FSH and LH before and after operation ; the levels of FSH and LH in patients with bilateral benign ovarian carcinoma after operation were significantly higher than those before operation and patients with unilateral benign ovarian carcinoma （P 〈 0. 05 ） ; in patients with bilateral benign ovarian carcinoma, there was no significant difference in serum estrogen level before and after opera- tion. Vaginal B ultrasound indicated that there was no significant difference in blood flow index, S/D and PI before and after operation, but the ovarian volume and amount of antral follicles after operation were significantly lower than those before operation. Conclusion： Compare to unilateral benign ovarian carcinoma enucleation, bilateral benign ovarian carcinoma enueleation affects ovarian function signifieantly, ovarian carcinoma enucleation has influence on ovarian reserve function, so it is important to protect ovarian reserve function in operation.