介入硬化与传统手术方法治疗卵巢巧克力囊肿对卵巢功能的影响

A Comparative Study of Sclerotherapy Procedure and Traditional Surgical Treatment for Chocolate Cyst of the Ovary and Their Effects on Ovary Function

目的：探讨介入硬化治疗和开腹卵巢巧克力囊肿剥除术后对卵巢功能的影响。方法：回顾性分析2008年3月～2012年3月我院超声引导下介入硬化治疗与经腹行巧克力囊肿剥除术108例临床资料。分为介入组66例和开腹组42例。所有患者分别于术前、术后3、6、12个月抽血测定促卵泡生成素（FSH）、促黄体生成素（LH）、雌二醇（E2）的水平，同时比较两组术中及术后随访的各项指标。结果：介入组术后3、6、12个月FSH、LH水平下降、E2水平升高，且与术前比较差异有统计学意义（P〈0．01）；开腹组术后3、6个月血清FSH、LH水平升高、E2水平下降，与术前比较差异有统计学意义（P〈0．01）；开腹组术后12个月血清FSH、LH水平与术前比较，差异无统计学意义；E2水平与术前及介入组比较，差异有统计学意义（P〈0．01）。两组患者在医疗费用、住院时间和心理精神影响、并发症及术后妊娠率方面差异有统计学意义（P〈0，01）；疗效与术后复发率两组间差异无统计学意义（P〉0．05）。结论：介入硬化治疗卵巢巧克力囊肿对卵巢功能较术前有明显改善，妊娠率提高；开腹巧克力囊肿剥除术后中、短期可影响卵巢功能，远期对卵巢功能改善不明显。介入硬化治疗与开腹治疗巧克力囊肿相比介入硬化具有创伤小，费用低，无需住院、术后恢复快，对病人精神心理影响小，可重复性好，妊娠率高等优点，是一种较为理想的微创治疗方法，值得推广。

Objective： Exploring the effects on ovary function after the ovarian sclerotherapy procedure and traditional surgical treatment for chocolate cyst of the ovary. Methods： An retrospective analysis on 108 clinical cases of chocolate cyst treated in my hospital from March 2008 to March 2012. Among the cases, 66 underwent the ultrasound - guided ovarian sclerotherapy procedure, and 42 had open surgeries. All the patients had the lab- oratory results of the serum levels of follicle- stimulating hormone （FSH）, luteotrophic hormone （LH） and estradiol （E2）, tested respectively before the treatment, 3 months, 6 months and 12 months after the treat- ment. By adding various index during and after treatment in the two groups, result from the comparisons be- tween the two groups are thus obtained. Results. The group with the ovarian sclerotherapy procedure had seen dropped level of FSH and LH, and the level of E2 increased after 3, 6 and 12 months（P 〈 0.01）. For the group with surgeries, the FSH and LH level increased, while E2 level dropped after 3 and 6 months. The difference between the figures before and after operation has statistical significance（P 〈 0.01）. The difference between the figures of FSH and LH levels after 12 months for those with surgeries remain quite the same. While the group＇ s E2 level is significantly different comparing with the level before surgeries or the group with the ovarian sele- rotherapy proeedure（P 〈 0.01）. However, considering the medical cost, time in hospital, psychological influ- ence, as well as post - procedural complications and pregnancy rate, the group with the ovarian sclerotherapy procedure enjoy a significant advantage compared to the group with surgeries（P 〈 0.01）. The comparison of therapeutic effect and incidence of cyst recurrence between the two groups is very small and has no statistical sig- nificance（P 〉0.05）. Conclusion. The ovarian sclerotherapy procedure for chocolate cyst has seen clear improve- ment of ovary functions and rise of pregnancy rate, while those with surgeries only have short- term improve- ment of ovary functions but without clear improvement in a long term, Comparing with the patients who hadsurgeries, those with ovarian sclerotherapy procedure have much smaller wounds, spend less, recover fast and don＇t have to be hospitalized, and further more, have little psychological influence and enjoy higher pregnancy rate. The ovarian sclerotherapy procedure is no doubt a safe and effective alternative to surgery.