腹腔镜下卵巢囊肿剥除术中两种止血方法的临床分析

Two different hemostatic methods in shelling out the ovary-cyst of sexual maturity women under laparoscopy

目的探讨腹腔镜下卵巢良性肿瘤剥除术中创面止血的最佳方法。方法选取收治的91例卵巢良性肿瘤患者,均行腹腔镜下卵巢肿瘤剥除术,术中采用电凝止血和缝合止血两种方法。电凝组46例,缝合组45例。统计患者的手术时间、手术出血量、术后恢复排气时间、术后病率,并于术前、术后时、术后6个月抽血检测垂体分泌卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)以判断卵巢功能。结果术后及术后6个月时电凝组患者FSH升高幅度明显大于缝合组(P<0.05);术后及术后6个月时电凝组患者E2水平下降幅度明显大于缝合组(P<0.05);术后及术后6个月时电凝组患者LH升高幅度明显大于缝合组(P<0.05);电凝组患者术后6个月时FSH≥12 U·L-1(卵巢储备功能降低)及FSH≥40 U·L-1(卵巢功能衰竭)的例数明显多于缝合组(P<0.05)。结论腹腔镜下卵巢良性囊肿剥除术时缝合止血比电凝止血有优势。

Objective To study two different hemostatic methods of electric coagulation and saturation after operation in shelling out ovary - cyst under laparoscopy. Methods Total 91 patients with ovary - cyst having operation indication were randomly chosen and divided into two groups： 46 cases for electric coagulation and 45 cases for saturation, according to hemostatic methods in the operation under laparoscopy. All the cases were not different on the operation time, and amount of bleeding. The serum level of FSH, LH and E2 of all the cases was inspected was monitored through transvaginal ultrasound as judging ovary reserve function before and after operation and 6 months later. Results There was statistic significance for serum level of FSH and 6 months later serum E2 level after operation and serum LH level in the 6 months of operation between two groups. The patients with serum FSH level more than 12U · L-I in the group of electric coagulation were more than those in the group of saturation in the 6 months of operation. Conclusion The hemostatic method of electric coagulation is more likely to decrease ovary reserve function than saturation method during shelling out ovary - cyst un- der laparoscopy.