腹腔镜下卵巢囊肿剥除术不同止血方法对卵巢功能影响的对照研究

Control study on influence of different hemostatic measures of iaparoscopic ovarian cyst removedon ovarian funcfion

目的探讨腹腔镜下卵巢囊肿剥除术不同止血方法对卵巢功能的影响。方法将70例卵巢囊肿患者按机械抽样法随机分为I组（23例）和1I组（47例），均择期行腹腔镜下卵巢囊肿剥除术，I组患者术中止血采取电凝法，Ⅱ组患者采取缝合法。比较两组术前及术后6个月雌二醇、卵泡刺激素（FsH）、黄体生成激素（LH）、窦状卵泡数、卵巢功能正常例数及卵巢储备功能下降例数。结果术后Ⅱ组卵巢功能正常率明显高于I组[80．9％（38／47）比39．1％（9／23）]（P〈0．05），雌二醇和窦状卵泡数显著高于I组[（198．44±24．4）pmol／L比（153．4±16．8）pmol／L，（7．1±2．4）个比（5．8±0．9）个]（P〈0．05），而FSH和FSH／LH显著低于I组[（10．584±4．57）U／L比（13．724±2．58）u／L，2．344±1．32比2．82±0．88]（P〈0．05）。结论腹腔镜下卵巢囊肿剥除术时，采用电凝止血会显著降低残留卵巢功能，而采用缝合法止血可有效保护卵巢功能。

Objective To explore the influence of different hemostatic measures of laparoscopie ovarian cyst removed on ovarian function. Methods Seventy patients with ovarian cyst who performed laparoscopic ovarian cysts removed between January 2009 and December 2010 were randomly divided into group I （23 cases） and group 1I （47 cases） by mechanical sampling. Group I with bleeding electrocantery, group II with suture. Estradiol, follicle puncture hormone （FSH）, luteinizing hormone （LH）,number of sinusoidal follicles, normal ovarian function and the number of dcehning ovarian reserve were compared in two groups before operation and after 6 months operation. Results After operation,the proportion of group II with normal ovarian function was significantly higher than that of group I [80.9% （38/47） vs. 39.1% （9/23）, P 〈 0.05 ], estradiol and number of sinusoidal follicles were significantly higher than those of group I [ （ 198.4 ±24.4） pmol/L vs. （ 153.4 ±16.8） pmol]L,7.1 ±2.4 vs. 5.8 ±0.9 ] （P 〈 0.05）, FSH and FSH/LH were significantly lower than those of group I [ （ 10.58 ±4.57） U/L vs. （ 13.72 ±2.58） U/L,2.34 ±1.32 vs. 2.82 ±0.88 ] （P 〈 0.05）. Conclusion During laparoseopic ovarian cyst removed ,using electrocantery can significantly reduce residual ovarian function, but using suture hemostasis can effectively protect residual ovarian function.