腹腔镜卵巢囊肿剔除术中不同止血方式对于卵巢功能的影响

Influences of different hemostatic methods on the ovarian function in laparoscopic ovarian cyst resection

目的探讨腹腔镜卵巢囊肿剔除术中不同止血方式对于卵巢功能的影响。方法本院行腹腔镜卵巢囊肿剔除术的单侧卵巢囊肿患者92例,随机分为3组:单极电凝组31例,双极电凝组30例,镜下缝合止血组31例。比较3组患者术前、术后1个月、术后3个月的月经变化、激素水平、手术时间、出血量、卵巢动脉血流参数、窦卵泡数及术后排卵等指标。结果镜下缝合止血组和双极电凝组的术后性激素水平恢复、排卵情况月经情况显著优于单极电凝组,镜下缝合止血组的术后的围绝经期综合征发生率显著低于电凝组,镜下缝合止血组术后的收缩期峰值流速(PSV)、窦状卵泡数目(AFC)与术前相比差异显著。结论镜下缝合止血方式可以保护卵巢储备功能,提高患者的卵巢功能和术后的生活质量,不良反应少,值得临床推广应用。

Objective To study the influences of different hemostatic methods on the ovari- an function in laparoscopie ovarian cyst resection. Methods Ninety - two patients with unilateral o- varian cyst in our hospital who undertook the laparoscopic ovarian cyst resection were randomly di- vided into monopolar electrocoagulation group （ n = 31 ）, bipolar coagulation group （ n = 30） and endoscopic hemostatic suture group （n = 31 ）. The indices of menstrual changes and hormone levels in preoperative operation, 1 month and 3 months after operation, operation time, bleeding volume, o- varian artery blood flow parameters, antral follicle count and postoperative ovulation of the three groups were compared. Results The postoperative recovery, sex hormone ovulation menstruation were significantly better in endoscopic hemostatic suture group and bipolar electric coagulation group than in monopolar electrocoagulation hemostasis endoscopic suturing group. Incidence rate of post- operative menopausal syndrome in endoscopic hemostatic suture group was significantly lower than that in electric coagulation groups. The levels of PSV and AFC in endoscopic hemostatic suture group after operation showed no significant difference with those before operation. Conclusion Thee laparoscopic suture hemostasis can protect ovarian reserving function and increase ovarian function with life quality of the patients after operation. It has fewer adverse reactions and is suitable for clinical application.