经阴穿刺治疗卵巢子宫内膜异位囊肿对卵巢储备功能的影响67例

The Impact On The Ovarian Reserve Function After The Treatment of Transvaginal Puncture On Ovarian Cysts

目的探讨经阴穿刺及囊肿剥除术对卵巢储备功能的影响。方法对比经阴道囊肿穿刺67例及囊肿剥除术59例患者术前及术后6个月卵泡刺激素、黄体生成素、雌激素水平的变化,并行阴道B超检测卵巢体积、卵巢间质血流峰值、窦卵泡数。结果囊肿剥除者,单侧术后卵泡刺激素、黄体生成素、雌激素,与术前相比差异无显著性(P>0.05),双侧与术前相比卵泡刺激素、雌激素均升高,差异有显著性(P<0.05),黄体生成素水平差异无显著性(P>0.05);而囊肿穿刺者无论单侧还是双侧,卵泡刺激素、黄体生成素、雌激素水平术前术后均无显著性差异(P>0.05)。在超声方面,单侧囊肿穿刺者手术侧及健侧在卵巢大小、卵巢间质血流峰值及窦卵泡数,差异无显著性(P>0.05),而单侧剥除者,手术侧较健侧减少,差异具有显著性(P<0.05)。结论囊肿剥除对卵巢储备功能有一定影响,而经阴道囊肿穿刺者对卵巢储备功能无影响。因此对于有生育要求的妇女,经阴道囊肿穿刺不失为首选方法。

Objective To explore the differences of the impact on the ovarian reserve function after vaginal cyst puncture and operation for benign ovarian cyst. Methods 67 patients of vaginal cyst puncture and 59 patients of cyst re- moved operation were chosen to compare and analyze the changes of their follicle-stimulating hormone （FSH）, luteinizing hormone（LH） and estrogen（E2） before and after the operation while observe the ovarian volume, peak of stroma blood flow and the number of sinus follicle by vaginal bultrasound. Results For the patients with operation for benign ovarian cyst, the lateral level of FSH, LH and E2 were not significantly different after operation （P〉0.05）, and the bilateral level of FSH and E2 were both significantly higher than before（P〈0.05） while no significant change was noticed in the level of LH. For the patients of vaginal cyst puncture, both lateral and bilateral level of FSH, LH and E2 were not significantly different （P〉 0.05）. By bultrasound, both the diseased side and the other side of the ovarian volume, stromwis blood flow and the number of sinus follicle of the patients with vaginal cyst puncture were not significantly different （P〉0.05）, while for the patients lap- aroscopic operation for benign ovarian cyst, the level of the diseased side decreased significantly than that of the other side （P〈0.05）. Conclusion The ovarian reserve function may impacted by the operation for benign ovarian cyst but vaginal cyst puncture. Therefore, vaginal cyst puncture will be recommended as the first choice for women with fertility.