不同止血方式对腹腔镜卵巢囊肿剥除术患者卵巢功能的影响

Influence of different hemostatic ways on ovarian functions in patients with laparoscopic ovarian cyst removal surgery

目的探讨不同止血方式对腹腔镜卵巢囊肿剥除术患者卵巢功能的影响。方法将本院收治的120例卵巢囊肿患者随机分为对照组、镜下缝合组、单极电凝组、超声刀组,每组各30例,分别采用缝合止血、镜下缝合止血、单极电凝止血、超声刀止血,检测并对比四组患者术前、术后1、3个月时的促黄体生成激素(LH)、卵泡刺激素(FSH)、雌二醇(E2)、孕酮(P)、睾酮(T)及月经变化情况。结果术前四组患者的LH、FSH、E2、P、T比较,差异无统计学意义(P>0.05);术后1、3个月四组患者的LH、E2、FSH比较,差异均有统计学意义(P<0.05),而P、T水平差异均无统计学意义(P>0.05)。术后1个月对照组的LH、FSH、E2水平明显低于其他三组,差异有统计学意义(P<0.05),术后3个月单极电凝组患者的E2水平明显低于其他三组,而LH、FSH明显高于其他三组,差异均有统计学意义(均P<0.05)。对照组与镜下缝合组患者的月经情况未见明显改变,单极电凝组6例患者月经异常,超声刀组4例患者出现月经异常。结论腹腔镜下卵巢囊肿剥除术镜下缝合止血和超声刀止血不加重对患者的卵巢功能的影响,而单极电凝止血可降低患者的近期卵巢功能。

Objective To study the influence of different hemostatic ways on ovarian function in patients with laparoscopic ovarian cyst removal surgery. Methods 120 ovarian cyst patients were randomly didved into control group, microscopically suture group, unipolar electricity group, ultrasound knife group, and each group of 30 cases, suture bleeding, under mirror suture bleeding, unipolar electricity blood, ultrasound scalpel pelvis bleeding were used, the promoting corpus luteum formation hormone （LH）, follicle-stimulating hormone （FSH）, estradiol （E2）, progesterone （P）, testosterone （T） and menstrual changes were detected and compared in preoperative between the four groups. Results The promoting corpus LH, FSH, E2, P, T compared in preoperative among the four groups, the differences were not statistically significant （P 〉 0.05）, the E2, FSH, LH compared in postoperative 1, 3 months between the four groups, the differences were statistically significant （P 〈 0.05）, but the difference in the level of P, T were not statistically significant （P 〉 0.05）. After one month the level of LH, FSH, E2 in the control group was significantly lower than the other three groups, the difference was statistically significant （P 〈 0.05）, 3 months after the level of E2 in unipolar electricity group was significantly lower than the other three, groups, and LH, FSH was higher than the other three groups, the difference was statistically significant （P 〈 0.05）. The menstruation of patients had not seen obvious change in the control group and the microscopically suture group. Unipolar electricity group of 6 patients menstrual abnormalities, ultrasonic knife group of 4 patients appear menstrual abnormalities. Conclusion Laparoscopie ovarian cyst strip is bleeding and microscopic suture bleeding not add to ultrasound scalpel patient＇s ovarian function, while the effect of unipolar electricity and pelvis can reduce the blood with recent ovarian function.