腹腔镜手术治疗卵巢囊肿中不同止血方式的应用效果分析

Effect of different hemostasis methods in laparoscopic surgery of ovarian cysts

目的 探讨腹腔镜手术治疗卵巢囊肿中不同止血方式的止血效果及对卵巢功能的影响。方法 将180例行腹腔镜手术治疗的卵巢囊肿患者随机分为两组,各90例。缝合组采取镜下缝合止血,电凝组采取双极电凝止血,比较两组术中情况、术后月经恢复及激素水平。结果 两组患者手术时间和术中出血量比较,差异均无统计学意义（P〉0.05）;术后随访9~12个月,缝合组月经恢复正常率为97.8%,高于电凝组的87.8%（P〈0.01）;两组术前雌二醇（E2）、卵泡刺激素（FSH）、促黄体生成素（LH）水平比较,差异均无统计学意义（P〉0.05）;术后1个月,两组E2水平均下降（P〈0.01）,FSH、LH水平均上升（P〈0.01）;两组孕酮（P）和睾酮（T）水平手术前后比较,差异均无统计学意义（P〉0.05）。结论 腹腔镜手术治疗卵巢囊肿中镜下缝合与电凝止血的效果相当,但镜下缝合止血对术后月经恢复及卵巢的近期功能影响更小。

Objective To compare the effect of different hemostasis methods in laparoscopic surgery of ovarian cysts. Methods One hundred and eighty cases of laparoscopic surgery in the treatment of ovarian cysts were divided into group A and group B accord- ing to the random number table extraction,90 cases in each group. Group A underwent endoscopic hemostasis ,while group B took bipo- lar coagulation hemostasis. Postoperative menstrual recovery and hormonal changes were compared between the two groups. Results There was no significant difference between the two groups in the average operation time and the average bleeding amount during surgery （ P 〉 0.05 ）. The two groups of patients were followed up for 9 ~ 12 months, and there were some differences in menstruation recovery rate, Group A was 97.8% ,while group B was 87. 8% （ P 〈 0. 01 ）. After one month, level of E2, FSH and LH in two groups had more obvious changes（ P 〈 0. 01 ） ,while no statistical difference before treatment（ P 〉 0. 05 ）. Levels of E2 in two groups were decreased （P 〈 0. 01 ）, while FSH, LH in two groups were increased （ P 〈 0.01 ）, Progesterone （P） and Testosterone （T） level changes in two groups had no statistical difference after surgery（ P 〉 0. 05 ）. Conclusion Effect of suture hemostasis and electric coagulation hemostasis in laparoscopic surgery in the treatment of ovarian cysts has no significant difference, but the impact of suture hemostasis on menstruation recovery and ovarian function is smaller.