腹腔镜下卵巢巧克力囊肿剥除术中创面使用双极电凝或缝合止血对卵巢分泌性激素的影响

Effects of bipolar electrocoagulation hemostasis versus suture hemostasis of surface of the wound in laparoscopic cystectomy for chocolate cyst of ovary on ovarian sexual hormones secretion

目的探讨腹腔镜下卵巢巧克力囊肿剥除术中创面采用双极电凝和缝合两种止血方法对术后卵巢分泌性激素的影响。方法选取单侧卵巢巧克力囊肿施行腹腔镜手术的患者80例,应用随机数字表法分成电凝组40例,缝合组40例,术中创面分别采用双极电凝和缝合两种止血方法。对所有患者术前,术后1个月、3个月、6个月分别抽血检测卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2),对两组以上指标进行比较,以评判手术对卵巢分泌性激素的影响。结果 (1)电凝组:术后1个月E2水平较术前明显降低,FSH、LH较术前明显升高,与术前比较差异有统计学意义(P<0.05);术后3个月,E2水平稍升高,FSH、LH稍降低,与术前比较差异仍有统计学意义(P<0.05);术后6个月E2值、FSH、LH值已逐渐恢复至术前水平(P>0.05)。(2)缝合组:术后1个月E2水平较术前降低,FSH、LH较术前升高,与术前比较差异有统计学意义(P<0.05);术后3个月,E2水平稍升高,FSH、LH稍降低,但与术前比较差异无统计学意义(P>0.05);术后6个月E2、FSH、LH值已恢复至术前水平,差异无统计学意义(P>0.05)。术后同一时间同一指标,电凝组对卵巢性激素分泌的影响均大于缝合组,发生卵巢储备功能减退人数多,差异有统计学意义(P<0.05)。结论腹腔镜下卵巢巧克力囊肿剥除术中无论使用双极电凝法或缝合法止血均对卵巢分泌性激素造成影响,尤以电凝止血法影响更为显著。卵巢分泌性激素功能在术后半年内可基本恢复正常。

Ob jective To explore the effects of bipolar electrocoagulation hemostasis versus suture hemosta -sis of surface of the wound in laparoscopic cystectomy for chocolate cyst of ovary on ovarian sexual hormones secre -tion.Methods Eighty patients with unilateral ovarian cyst who underwent laparoscopic cystectomy were randomly di -vided into two groups：bipolar electrocoagulation group and suture group ,with 40 cases in each group .Patients in bipo-lar electrocoagulation group received bipolar electrocoagulation for hemostasis ,and patients in suture group received suture for hemostasis.The serum levels of follicle stimulating hormone （FSH）, luteinizing hormone（LH）, estradiol （E2） were detected respectively before the operations and at 1st month,3rd month and 6th month after operation.Re-sults （1）In bipolar electrocoagulation group , compared with the levels before operation ,the E 2 level had obviously reduced , FSH and LH levels had obviously risen at the 1st month after operation , the differences had statistically sig-nificance（P〈0.05）;the E 2 level had slightly risen, FSH and LH levels had slightly reduced at the 3rd month after operation, the differences had statistically significance （P〉0.05）; the E2, FSH and LH level had returned to the levels before operations at the 6th month after operation（P〉0.05）.（2）In suture group, compared with the levels before operation, E2 level had reduced, FSH and LH levels had risen at the 1st month after operation, the differences had statistically significance （ P〈0.05 ）;the E2 level had slightly risen , FSH and LH levels had slightly reduced at the 3rd month after operation, the data had no statistically significance （P〉0.05）; the E2, FSH and LH level had returned to the levels before operations at the 6th month after operation（P〉0.05）;Compared with the suture group, the bipolar electrocoagulation group had more influence on ovarian sexual hormones secretion （ P〈0.05 ） .Conclusion Both of the two hemostatic methods in laparoscopic cystectomy for ovarian endometriotic cyst have effects on sexual hormones secretion ,especially electrocoagulation hemostasis has more .In most of patients the ovarian sexual hormones secretion can be recovered to normal level basically in 6 months after operation .