腹腔镜下卵巢囊肿剥除术不同止血方式对残留卵巢功能的影响

Effect of different methods of hemostasis on residual ovarian function after laparoscopic ovarian cystectomy

目的探讨腹腔镜下卵巢肿瘤剥除术采用电凝止血与缝合止血对卵巢功能的影响。方法选取合适的患者80例,采用随机数字的方法分为观察组和对照组各40例,观察组应用缝合止血法,对照组应用电凝止血法,比较两组患者卵巢功能恢复情况。结果观察组术中出血量(52.98±5.10)ml,对照组术中出血量(51.37±5.28)ml,二者差异无统计学意义(P>0.05)。术后1个月,两组患者血清E2、PSV及卵巢窦卵泡数均下降,FSH均升高,与术前相比差异有统计学意义(P<0.05),并且对照组患者变化幅度大于观察组,差异有统计学意义(P<0.05);术后6个月观察组患者血清E2、FSH、PSV及卵巢窦卵泡数恢复术前水平,差异无统计学意义(P>0.05),对照组与术前比较差异仍有统计学意义(P<0.05)。两组患者手术前后血清LH水平变化不大,差异均无统计学意义(P>0.05)。观察组患者基础内分泌激素水平均在正常范围,而对照组卵巢储备功能下降8例、卵巢功能衰竭1例,二者差异有统计学意义(P<0.05)。结论腹腔镜下卵巢囊肿剥除术中应用缝合止血对卵巢储备功能影响小,卵巢功能得到最大程度的保护,有利于卵巢功能恢复。

Objective To investigate the effect of electrocautery and suture hemostasis on residual ovarian function after laparoscopic ovarian cystectomy. Methods 80 patients were divided randomly into observation group （40 eases） and control group （40 cases）. The observation group used suture hemostasis, the control group used electrocautery, to compare ovarian function recovery in two group. Results The intraoperative bleeding was （52. 98 ± 5. 10） ml in the observation group, and （51.37 ± 5.28）ml in the control group（P 〉0. 05）. Serum E2, PSV and ovarian antral follicle decreased, and serum FSH increased in two group 1 month after operation（ P 〈 0.05 ）, the extent of variation in the control group is greater than the observation groups, and the difference was statistically significant （P 〈 0. 05）. Serum E2, PSV, FSH and ovarian antral follicle recovered in the observation group 6 month after operation （P 〉 0.05 ）, but there was a significant difference in the control group（ P 〈 0. 05 ）. The changes of serum LH level before and after operation in two group was small（P 〉 0. 05 ）. Basic endocrine hormone levels was normal in the observation group, in the control group 8 cases were decreased ovarian reserve function, 1 case was ovarian function failure （P 〈 0. 05）. Conclusion Suture hemostasis in laparoscopic ovarian cystectomy have less influence of ovarian reserve function, and been good for ovarian function recovery.