腹腔镜下输卵管积水的不同处理方式对卵巢储备的影响

The effect of different laparoscopic procedures for hydrosalpinx on ovarian reserve function

目的:探讨腹腔镜处理输卵管积水的不同方式对卵巢储备功能的影响。方法:输卵管积水行腹腔镜手术患者95例,按手术方式分为3组:A组(n=32)行输卵管单纯造口术,B组(n=32)行输卵管近端结扎远端造口术,C组(n=31)行双侧输卵管切除术。观察患者手术前及术后1个月、3个月的血清雌二醇(E2)、促卵泡生成素(FSH)、促黄体生成素(LH)、抗苗勒管激素(AMH)水平及窦状卵泡数(AFC)的变化。结果:术前3组患者卵巢储备功能指标差异无统计学意义(P>0.05)。术后1个月3组E2、FSH、FSH/LH、AMH水平以及AFC差异均有统计学意义(P<0.05),术后3个月3组上述指标差异无统计学意义(P>0.05)。结论:腹腔镜下双侧输卵管切除术与卵巢储备功能一过性降低相关,但3种手术方式对卵巢远期储备功能的改变无相关性。

Objective：To explore the effect of different laparoscopic procedures for hydrosalpinx on ovarian reserve function. Methods：95 patients of hydrosalpinx on laparoscopic procedures were randomly divided into three groups acording to the mode of operation. Group A（n=32）were treated with tubal colostomy surgery alone,group B（n=32）were treated with porxiam1 tubal blocking and distal tubal salpingostomy,group C（n=31）were treated with laparoscopic bilateral salpingectomy for hydrosalpinx. The levels of serum estradiol（E2）,follicle-stimulating hormone（FSH）,luteinizing hormone（LH）,anti-mullerian hormone（AMH）and sinus follicle number of patients with preoperative and postoperative 1 month,3 months were obtained. Results：Before surgery,there was no significant difference in ovarian reserve function between the three groups（P 0.05）. One month after laparoscopic surgery, the level of E2,FSH,FSH/LH,AMH and the number of AFC in three groups were significantly different（P 0.05）. Three months later,the difference was not statistically significant（P 0.05） in the three groups. Conclusion：Laparoscopic bilateral salpingectomy is related to transitional decrease of ovarian reserve function. The three modes of surgery are not ralated to long-term alteration of ovarian reserve function.