腹腔镜卵巢囊肿剥除术使用单、双极电凝及缝合止血对卵巢功能的影响

A study of the influence on the ovarian function after using the monopolar and bipolar electrocoagulation and suture hemostasis respectively shelled out the ovarian cyst by laparoscope

目的：探讨腹腔镜卵巢囊肿剥除术中使用单、双极电凝及缝合止血对卵巢功能的影响。方法：选择90例单侧卵巢良性肿瘤患者，均行腹腔镜卵巢囊肿剥除术，按不同的止血方法将其分单极电凝组、双极电凝组、镜下缝合组。分别于术前、术后3个月、术后6个月抽血检测E2、FSH、LH，并术后随访。结果：单、双极电凝组术后发生月经改变及围绝经期综合征明显多于镜下缝合组（P〈0．05）。3组病例术后3个月和术后6个月较术前均出现E2下降和FSH、LH增高，其中单、双极电凝组分别与术前比较有显著性差异（P〈0．05）。此两组分别与镜下缝合组术后E2、FSH、LH的比较有显著性差异（P〈0．05）。双极电凝组术后3个月的E2较单极电凝组高，有显著性差异（P〈0．05），该两组的E2术后6个月较术后3个月增高，也有显著性差异（P〈0．05）。结论：腹腔镜下卵巢囊肿剥除创面采用单极电凝止血会引起对卵巢功能的损害．而使用锖下缝合止血或合理地使用双极电凝止血可重好地保留其功能．

Objective： To study the influence on the ovarian function after using the monopolar and bipolar electrocoagulation and suture hemostasis respectively shelled out the ovarian cyst by laparoscope. Methods： 90 patients with unilateral ovarian benign cyst underwent laparoscope were assigned to three groups by different hemostasia methods including monopolar electrocoagulation bipolar electrocoagulation and suture hemostasis as the control group. All the patients followed up for 6month. Results： The monopolar and bipolar group had more menstruation abnormality and perimenopausal syn-drome than the suture groups（P〈0.05）. There was significant difference compared with levels before operations in the monopolar group and bipolar group respectively （P〈0.05）. The postoperative hormone levels of the monopolar group and bipolar group also re-spectively had significant difference compared with those of the suture group （P〈0.05）. At 3months after the operations, the levels of E2 in the bipo-lar group were significantly higher than those in the monopolar group （P〈0.05）.The postoperative levels of E2 in the monopolar group and bipolar group were significantly higher at 6months than at 3months（P〈0.05）. Conclusion： Using the monopolar and bipolar electrocoagulation to stanch when stripped of the overian cyst by laparoscope can lead to the damage of the ovarian function. The suture un- derwent laparoscope is a good protective measure.