腹腔镜卵巢囊肿剥除术中不同止血方法对卵巢功能影响的研究

Research of influence of different hemostasis for laparoscopic oophorocystectomy on ovarian function

目的探讨腹腔镜卵巢囊肿剥除术中不同止血方法对卵巢功能的影响。方法将80例单侧良性卵巢囊肿行腹腔镜卵巢囊肿剥除术的患者随机分为观察组和对照组,每组各40例。观察组术中采用缝合止血法,对照组术中采用传统的双极电凝止血法。观察两组患者术前、术后3月、6月的雌二醇(Estradiol,E2)、促卵泡激素(follicle-stimulating hormone,FSH)、促黄体生成素(luteinizing hormone,LH)、孕酮(progestcrone,P)水平,术后月经变化及妊娠率。结果观察组患者术后3个月各激素水平与术前比较,差异无统计学意义(P>0.05);对照组患者E2下降,LH、FSH升高,与术前比较差异有统计学意义(P<0.05);术后6个月,两组激素水平与术前比较差异无统计学意义(P>0.05),观察组月经改变率和妊娠率明显优于对照组(P<0.05)。结论腹腔镜下卵巢囊肿剥除术中创面电凝止血会引起卵巢功能的损害,而采用缝合止血可更好的保留卵巢功能,有利于保留患者生育功能,值得临床推广应用。

Objective To explore the influence of different hemostasis for laparoscopic oophorocystectomy on ovarian function.Methods 80 patients with benign ovarian neoplasm underwent laparoscopic oophorocystectomy were randomly divided into observation group and control group,with 40 cases in each group. The observation group received suture hemostasis,while the control group received conventional bipolar coagulation. Estradiol（ E2）,follicle stimulating hormone（ FSH）,luteinizing hormone（ LH）,progestcrone（ P） were measured before operation,3 and 6 months after operation. Moreover,menstruation and pregnancy rate after the surgery were monitored. Results The hormone levels in observation group 3 months after operation had no significant difference compared to that before operation（ P〉0. 05）. E2 decreased and LH,FSH elevated in the control group,which had significant difference compared to that before operation（ P〈0. 05）. No significant differences were found in two groups 6 months after operation compared with that before operation（ P〉0. 05）. The menstruation change rate and pregnancy rate in observation group were significantly better than the control group（ P〈0. 05）. Conclusion The bipolar coagulation for laparoscopic oophorocystectomy can cause ovarian function damage,while suture hemostasis can reserve ovarian function and facilitate the retention of reproductive function of postoperative patients,it is worthy of clinical application.