腹腔镜卵巢囊肿剔除术对患者卵巢贮备功能及基质血流的影响

Effects of laparoscopic ovarian cyst elimination on ovarian reserve function and stroma blood flow

目的探讨腹腔镜卵巢囊肿剔除术对患者卵巢储备功能和基质血流的影响。方法选取余杭区第二人民医院妇产科卵巢囊肿患者51例,随机分为观察组26例和对照组25例,分别采用腹腔镜卵巢囊肿剔除术和开腹卵巢囊肿剔除术进行治疗;以治疗前1d、治疗后1个月、2个月、及3个月为观察点,采用彩色多普勒超声测定患者卵巢基质血流搏动指数(PI)、阻力指数(RI)、收缩末期峰值(S)与舒张末期峰值(D)的比值(S/D),及收缩期峰速(PSV),同时取患者空腹外周血,采用ELISA试剂盒测定血清卵泡刺激素(FSH)、雌激素(E_2)、促黄体激素(LH)水平。结果在变化趋势上,S/D与PSV先减后增(u值分别为1.16和1.76,均P<0.05);RI与PI先增后减(u值分别为-1.32和-1.45,均P<0.05);E_2表现为先减后增(u=1.78,P<0.05);FSH及LH表现为先增后减(u值分别为-1.26和-1.56,均P<0.05)。治疗前,观察组PSV、S/D、RI、PI、FSH、E_2和LH等指标与对照组相比,差异无统计学意义(t值分别为1.67、0.87、1.01、1.21、1.22、1.14和1.02,均P>0.05);术后1个月,观察组各项指标均显著优于对照组(t值分别为8.79、6.56、5.61、6.98、7.89、8.09和7.99,均P<0.05)。结论腹腔镜卵巢囊肿剔除术对患者卵巢基质供血损伤小,卵巢储备功能恢复快,临床疗效和安全性均可获得保障。

Objective To explore the effects of laparoscopic ovarian cyst elimination on ovarian reserve function and stromal blood flow . Methods Fifty-one cases with ovarian cyst were selected from the department of obstetrics and gynecology of Yuhang District No .2 Hospital , and they were randomly divided into two groups .Twenty-six cases in observation group were treated with laparoscopic ovarian cyst elimination, while 25 cases in control group were treated with conventional ovarian cyst elimination .At one day before therapy , 1 month, 2 month, and 3 month after treatment color Doppler ultrasound was used to detect pulsatility index （ PI） , resistant index （ RI） , S/D and PSV, respectively.Meanwhile, peripheral blood was extracted to detect serum FSH , E2, and LH levels with ELISA kit.Results Indexes of S/D, PSV, and E2 decreased at first and then increased （u value was 1.16, 1.76 and 1.78, respectively, all P〈0.05）, while PI, RI, LH and FSH reversed on the trend （u value was -1.32, -1.45, -1.26 and -1.56, respectively, all P〈0.05）.There were no significant differences between groups in PSV , S/D, RI, PI, FSH, E2 and LH before treatment （t value was 1.67, 0.87, 1.01, 1.21, 1.22, 1.14 and 1.02, respectively,all P〉0.05）, while all the indexes were significantly superior one month after treatment （t value was 8.79, 6.56, 5.61, 6.98, 7.89, 8.09 and 7.99, all P〈0.05）.Conclusion Laparoscopic ovarian cyst elimination has little damage on ovarian stromal blood flow , and ovarian reserve function recovers soon .Clinical efficacy and safety can be ensured .