腹腔镜下卵巢囊肿剥除术后创面处理方法对残留卵巢储备功能的影响

Effects of Wound Treatment Methods on Residual Ovarian Reserve Function after Laparoscopic Ovarian Cystectomy

目的探讨应用不同方法处理腹腔镜下卵巢囊肿剥除术后创面对残留卵巢功能的影响。方法选取新疆生产建设兵团医院妇科收治的120例卵巢囊肿患者,行腹腔镜下剥除术。依对创面给予的相应止血治疗方法随机分为3组:电凝组、超声组与缝合组,每组各40例。检测3组患者术前、术后即时、术后3个月、术后6个月时月经第2天外周静脉血中促卵泡素(FSH)、黄体生成素(LH)、雌二醇(E2)水平,并行经阴道超声测定双侧卵巢储备卵泡数量。同时记录患者术后相应时间月经变化及临床表现。结果术后电凝组患者FSH、LH、E2水平变化最为明显,超声组患者次之,缝合组患者变化最小且恢复最快(P<0.05)。电凝组患者术后储备卵泡数量减少最明显,且不良反应发生率较高。结论对腹腔镜下卵巢囊肿剥除术后的创面,应用电凝止血对残留卵巢功能影响最大,超声止血与缝合止血对其功能保护较好。

Objective To investigate the influence of wound treatment methods on residual ovarian reserve function after laparoscopic ovarian cystectomy.Methods A total of 120 patients with ovarian cyst who underwent laparoscopic ovarian cystectomy in the hospital were randomly divided into three groups in terms of different wound treatment methods：electric coagulation group,ultrasound group and suture group,with 40 cases in each group.The levels of follicle stimulating hormone（FSH）,luteinizing hormone（LH）,and estradiol（E2）were detected in the blood before and immediately after the operation,2days after menstruation at postoperative 3and 6 months,and the number of ovarian reserve follicles determined by transvaginal ultrasound.The changes of menstruation and clinical manifestations of the patients were recorded at the same time.Results The levels of LH,E2 and FSH were dramatically changed in electric coagulation group,which was followed by the ultrasonic group.Patients in the suture group had the smallest changes of these indices and recovered quickly（P〈0.05）.In the electric coagulation group relative to the other two groups,the number of ovarian reserve follicles was significantly decreased and the incidence of adverse reactions was profoundly increased.Conclusion Electric coagulation greatly adversely affects the residual ovarian reserve function after laparoscopic ovarian cystectomy,and ultrasonic and suture hemostasis techniques can help to protect ovarian function.