不同止血方式对腹腔镜下卵巢囊肿剔除术后卵巢功能的影响

Effects on Ovarian Function of Different Hemostatic Methods in Laparoscopic Ovarian Cystectomy

目的:观察腹腔镜下卵巢囊肿剔除术中双极电凝止血和缝合止血对卵巢良性肿瘤患者卵巢功能的影响。方法:选择2012年7月-2013年7月在我院妇科进行腹腔镜卵巢囊肿剔除术的卵巢良性肿瘤患者60例,随机分成观察组和对照组。其中,观察组30例使用缝合止血,对照组30例使用双极电凝止血。分别于术后3个月、6个月测定两组患者的卵巢基质内动脉血流参数、性激素水平,观察其变化情况。结果:术后3个月、6个月与术前相比,患者卵巢基质内动脉舒张末期最低血流速度(EDV)、收缩期峰值流速(PSV)、阻力指数(RI)差异均无统计学意义(P>0.05)。术前两组促卵泡素(FSH)、促黄体生成素(LH)和雌二醇(E2)激素水平相比差异均无统计学意义。术后第3、6个月,观察组患者的FSH、LH水平均低于对照组,E2水平均高于对照组,差异均具有统计学意义(P<0.05)。结论:腹腔镜下卵巢囊肿剔除术中双极电凝止血和缝合止血方式对患者的卵巢功能均有一定的影响,缝合止血方式对卵巢功能的保护优于双极电凝止血方式,更有利于患者的恢复。

Objective：To observe the influence on ovarian function of bipolar coagulation and sutured nemosrasis m laparoscopic ovarian cyst excision in patients with benign ovarian tumors. Methods： 60 patients with benign ovarian tumors were treated in department of obstetrics and gynecology of our Hospital from July 2012 to July 2013. The patients were randomly divided into observation group（ 39 cases） and control group （30 cases）. Patients in observation group were treated with sutured hemostasis in laparoscopic ovarian cyst excision and patients in control group were treated with bipolar eoagulation. Serum estradiol （ E2 ）, follicle stimulating hormone （FSH）, luteinizing hormone （LH） and end-diastolic volume（EDV）, peak systolic velocity（PSV）, resistance index（RI） in ovarian stromal artery of all the patients were recordeded before and 3 and 6 months after surgery. Results.-EDV, PSV, RI in ovarian stromal of two groups were compared before and 3 months, 6 months after surgery, there was no significant difference （P〉0. 05）. FSH, LH, E2 levels in the two groups before the surgery had no significantly difference（P〉0. 05）. 3 naonths, 6 months after surgery , FSH and LH levels in observation group were lower than the control group, E2 level was higher than that in the control group, there were significant differences （P〈0. 05）. Conclusion：Bipolar coagulation and sutured hemostasis methods in Laparoscopic ovarian cyst excision both have a certain influence on ovarian function, however, sutured hemostasis shows less influence and more conducive to patient recovery.