腹腔镜卵巢手术对卵巢储备功能的影响

The observation of ovarian reserve function after laparoscopic ovarian surgery

目的:观察腹腔镜卵巢手术对卵巢储备功能的影响。方法:对44例良性卵巢疾病患者采用腹腔镜手术治疗,于月经周期第8～12天施行手术。术后随访半年以上,观察月经情况。于术前及术后第1、3个月经周期的第3天采用放射免疫分析法测定FSH、E2及LH水平,判断卵巢储备功能。结果:术后第1个月经周期,42例(95.5%)正常,2例(4.5%)推迟,至第2个周期恢复正常。随访半年内,术后月经正常39例(88.6%),4例(9.1%)月经量较术前减少,减少量为20%～30%,1例(2.3%)月经稀发。所有患者术后第1个周期均出现E2下降,FSH、LH增高现象,与术前比较差异有统计学意义(P<0.05),至第3个周期时,E2有所增高,而FSH、LH下降,大多数都恢复至正常,与术前比较差异无统计学意义的(P>0.05)。第3个周期时6例(13.6%)有卵巢储备功能下降,未发现卵巢功能衰竭者,其余38例(86.4%)患者卵巢储备功能正常。结论:腹腔镜卵巢手术一定程度上会影响患者的卵巢储备功能,应该采取相应的预防措施。

Objective：To observe the ovarian reserve function after laparoscopic ovarian surgery.Methods：44 patients with benign ovarian disease were treated by laparoscopic surgery,who were operated at 8 to 12 days in the menstrual cycle.We conducted six months followed up to observe the menstruation.FSH,E2 and LH levels were measured by radioimmunoassay at preoperative and postoperative 1,3 of the menstrual cycle day 3 to determine the ovarian reserve.Results：At the first menstrual cycle after surgery,42 patients（95.5%） were normal,2 patients（4.5%） menstrual delayed,at the second cycle,it back to normal.Within six months follow-up,39 patients（88.6%） had normal menstruation,4 patients（9.1%） with menstrual flow decreased,which reduce about 20%-30%,and a patient（2.3%） had menstrual sparse hair.All the patients had E2 declined and FSH,LH increased at the first cycle（P0.05）,at the third cycle,E2 slightly increased,while FSH,LH decreased.Most of the patients were returned to normal（P0.05）.At the third menstrual cycle,6 patients（13.6%） had decreased ovarian reserve,no patients with ovarian failure were found,and the remaining 38 patients（86.4%） had normal ovarian reserve.Conclusion：Laparoscopic ovarian surgery can affect the ovarian reserve,which should take appropriate precautions.