卵巢囊肿剥出术不同止血方式对卵巢功能的影响

Effect of different hemostasia methods on ovarian function in ovarian surgery

目的通过检测抗苗勒管激素(AMH)在卵巢良性囊肿不同止血方式治疗中的变化,研究其在卵巢功能变化监测中的意义,探讨不同止血方式对卵巢功能的影响。方法选取因卵巢良性囊肿行腹腔镜下卵巢囊肿剥出术的患者90例,其中50例行双极电凝剥离面止血(电凝组),40例行创面缝合止血(缝合组),测定患者术前、术后第2 d、1个月、3个月血清中AMH、卵泡刺激素(FSH)、黄体生成素(LH)和雌二醇(E2)水平。结果电凝组内AMH术前与术后第2 d、1个月比较差异有统计学意义(P<0.05),与术后3个月比较差异无统计学意义(P>0.05);电凝组内FSH、LH及E2术前与术后第2 d、1个月、3个月比较,差异均无统计学意义(P>0.05);缝合组内AMH、FSH、LH及E2术前与术后第2 d、1个月、3个月比较,差异均无统计学意义(P>0.05)。结论 AMH监测卵巢功能变化更可靠、更敏感;不同手术方式对卵巢功能近期有影响。

Objective To study the function of the anti-mullerian hormone（ AMH） in monitoring the ovarian function change by detecting the level of AMH in benign ovarian cyst treatments with different hemostasia methods,and discuss the effect of different surgical methods on ovarian function. Methods A total of 90 patients with benign ovarian cyst underwent laparoscopic ovarian surgery were assigned to two groups,with the bipolar electrocoagulation group of 50 patients,namely the electrocoagulation group and the incision-suture group of 40 patients,namely the suture group. The levels of serum AMH,follicle-stimulating hormone（ FSH）,luteinizing hormone（ LH） and estradiol（ E2） were measured before surgery and in 2 days（ 2d）,1 month（ 1m）,3 month（ 3m） after surgery respectively and compared between the two groups preoperatively and postoperatively. Results The AMH levels differences between at pre-operation and in postoperative 2d and 1m in the electrocoagulation group had statistical significance（ P〈0. 05）,while compared with in the postoperative 3m,the difference was not statistically significant（ P〉0. 05）. Meanwhile,the levels differences of FSH,LH and E2 had no statistical significance in each stage between preoperatively and postoperatively（ P〉0. 05）. In the suture group,no statistical significance was found on the differences in AMH,FSH,LH and E2 between in pre-operation and in 2d,1m and 3m of post-operation,and the differences were not statistically significant（ P〉0. 05）. Conclusion AMH is more reliable and more sensitive in monitoring ovarian function,and the different operation methods have short effects on the ovarian function.