腹腔镜卵巢囊肿剔除术中不同止血方式对卵巢功能的影响

Application hemostatic effects of different laparoscopic ovarian cyst excision ways on ovarian function

目的比较腹腔镜卵巢囊肿剔除术中不同止血方式对卵巢功能的影响。方法 106例卵巢囊肿患者根据腹腔镜卵巢囊肿剔除术中止血方式分为缝合组(n=56)和电凝组(n=50),术后进行6个月的随访,观察两组患者月经和排卵情况及激素水平,并行彩超检查患者卵巢间质动脉血流收缩期峰值流速(PSV)、窦卵泡数及卵巢大小。结果缝合组患者恢复排卵的比例为82.1%,明显高于对照组的64.0%,差异有统计学意义(P<0.05)。术后6个月,缝合组患者血清促卵泡成熟激素(FSH)、促黄体生成素(LH)、雌二醇(E2)水平与术前比较,差异无统计学意义(P>0.05);但电凝组术后6个月的FSH及LH水平明显高于术前,E2明显低于术前,与缝合组差异均有统计学意义(P<0.05)。电凝组患者窦卵泡数较术前明显减少,且明显低于缝合组,差异有统计学意义(P<0.05)。结论腹腔镜卵巢囊肿剔除术中采用缝合止血比电凝止血法更有利于保护患者的卵巢功能。

Objective To compare application hemostatic effects of different laparoscopic ovarian cyst excision ways on ovarian function. Methods 106 patients with ovarian cysts treated by laparoscopic ovarian cyst excision were enrolled in the study and divided into electrocoagulation group（ n = 50） and suture group（ n = 56） depending on the hemostatic way. After followed-up for 6 mo,the menstruation,ovulation,hormone levels,peak systolic velocity（ PSV）,antral follicle count and ovarian size between the two groups were observed. Results Ovulation restore rate in suture group was 82. 1%,significantly higher than that of the electrocoagulation（ 64. 0%）（ P〈0. 05）; After 6 mo,compared with before the surgery,there was no significant differences in serum follicle stimulating hormone（ FSH）,luteotropic hormone（ LH）,estradiol（ E2） in the suture group（ P〈0. 05）,but FSH and LH levels in electrocoagulation group were significantly higher and E2 was significantly lower than before surgery（ P〈0. 05）. Antral follicle count in the electrocoagulation group was significantly reduced compared with before surgery and significantly lower than that of the suture group（ P〈0. 05）. Conclusion Laparoscopic ovarian cyst excision with suture hemostasis is better than electrocoagulation in protecting ovarian function.