腹腔镜卵巢囊肿剔除术止血方式对卵巢功能的影响

Influence of Difference Hemostasis Methods on Ovarian Function after Laparoscopic Ovarian Cystectomy

目的探讨腹腔镜下卵巢囊肿剔除术中不同止血方式对卵巢功能的影响。方法选择双侧卵巢囊肿患者100例,均行腹腔镜下囊肿剔除术。将患者随机分成两组,电凝止血组和压迫止血组,每组50例,观察术后卵巢早衰发生率。患者分别于术前、术后6个月抽血测定血清雌二醇、孕酮(P)、卵泡刺激素(FSH)、黄体生成素(LH)的水平,并进行术后随访。结果两组患者术后1年卵巢早衰发生率比较,差异有统计学意义(P<0.05);两组患者术前血清雌二醇、P、FSH、LH水平比较,差异均无统计学意义(P>0.05);两组患者术后血清雌二醇、FSH水平比较,差异均有统计学意义(P<0.01),而血清P、LH水平比较,差异均无统计学意义(P>0.05)。结论腹腔镜下卵巢囊肿剔除术中采取电凝止血对卵巢功能影响大,易引起卵巢早衰;术中采取镜下压迫止血,尽可能减少电凝,可更好地保护卵巢功能。

Objective To study the influence of difference hemostasis methods on the ovarian function after laparoscopic ovarian cystectomy.Methods One hundred patients with bilateral ovarian cysts undergoing laparoscopic ovarian cystectomy were divided randomly into groups A （receiving electrocoagulation hemostasis） and B （receiving hemostasis by compression）,50 in each.The incidence of premature ovarian failure was observed after operation.Blood was drawn to determine serum estradial （E2）,progesterone （P）,follicle stimulating hormone （FSH）,luteinizing hormone （LH） before operation or 6 months after,and follow-ups were performed.Results There was significant difference in incidence of premature ovarian failure between 2 groups 1 year after operation （P0.05）,but not in levels of serum E2,FSH and LH （P0.05）.There was significant difference in E2 and FSH levels （P0.01） after operation,but not in P and LH levels （P0.05）.Conclusion Electrocoagulation hemostasis in laparoscopic ovarian cystectomy has great impacts on ovarian functions,easily inducing premature ovarian failure.Laparoscopic hemostasis by compression should be used to reduce electrocoagulation as little as possible,to protect ovarian functions.