腹腔镜卵巢囊肿剔除术不同止血方式对卵巢良性肿瘤患者卵巢功能的影响研究

目的分析腹腔镜卵巢囊肿剔除术不同止血方式对卵巢良性肿瘤患者卵巢功能的影响。方法将88例行腹腔镜卵巢囊肿剔除术的卵巢良性肿瘤患者按照术中不同止血方式分为2组,各44例,A组行缝合止血,B组行双极电凝止血,观察2组患者术中手术情况、卵巢储备功能情况等。结果 A组患者手术时间(52.4±12.5)min长于B组的(40.8±10.6)min(P<0.05);出血量(83.6±20.8)m L多于B组(59.4±18.2)m L(P<0.05);A组住院时间为(7.8±1.9)d,B组住院时间为(7.5±1.6)d,2组患者住院时间比较差异无统计学意义。A组术后激素变化差异有统计学意义,优于B组(P<0.05);A组术前(6.8±1.2)F 0,术后(5.6±1.4)F 0;B组术前(6.5±1.3)F 0,术后(3.4±1.5)F 0;2组术后对比A组患侧卵巢窦卵泡数高于B组,差异有统计学意义(t=7.112,P<0.05)。A组术前子宫截面面积(4.1±1.5)cm2,B组术前子宫截面面积为(4.0±1.4)cm2;A组术后子宫截面面积(4.2±1.4)cm2,B组术后子宫截面面积为(4.1±1.5)cm^2;2组患者手术前后子宫截面面积差异无统计学意义;A组患者术前PSV(12.6±1.6)cm/s与B组患者的(12.5±1.5)cm/s差异无统计学意义;术后3个月A组患者PSV为(11.8±1.4)cm/s显著优于B组患者的(5.9±1.5)cm/s(P<0.05)。结论腹腔镜卵巢囊肿剔除术治疗卵巢良性肿瘤,术中缝合止血方式虽然会相对延长手术时间,增加术中出血量,但对卵巢功能影响较小,术后子宫恢复较好,对卵巢功能影响较小,值得临床应用及推广。

Objective To analyze the impact of laparoscopic ovarian cystectomy in the ovarian function for patients with benign ovarian tumor. Methods 88 patients with benign ovarian tumor of receiving the laparoscopic ovarian cystectomy were divided into two groups according to different intraoperative hemostasis. Group A adopted the suturing method and Group B adopted the bipolar coagulation hemostasis. The operation conditions like intraoperative condition and ovarian reserve function of two groups was observed. Results The operation time of Group A was longer than that of Group B; the bleeding quantity of Group A was more than that of Group B （P〈0.05）; the hospitalization time of two groups was not different; after surgery, the hormone of Group A was not significantly different, which it was better than that of Group B; the number of antral follicles of bilateral ovaries of Group A was more than that of Group B （P〈0.05）; before and after surgery, the sectional area of uterus of two groups was not different; before surgery, PSV of two groups was not different; after 3 m of surgery, PSV of Group A was significantly better than that of Group B （P〈0.05）. Conclusion The laparoscopic ovarian cystectomy has an obvious effect in the treatment of benign ovarian tumor. Although the suturing hemostasis will comparatively prolong the operation time and enhance the bleeding quantity during surgery, it will have fewer impacts in the ovarian function and better promote the uterus recovery. It is worthy of clinical application and promotion.