腹腔镜下卵巢囊肿剥除术后缝合与电凝止血对卵巢功能的影响

Effect of Suture and Coagulation Hemostasis on Ovarian Function after Laparoscopic Ovarian Cyst Removal

目的：探究腹腔镜下卵巢囊肿剥除术后缝合与电凝止血对卵巢功能的影响。方法：选择2014年5月~2015年12月期间我院收治卵巢囊肿患者78例为研究对象,两组患者均行腹腔镜下卵巢囊肿剥除术,根据患者术中止血方式的不同将其分为观察组（41例）和对照组（37例）;观察组术中采用双极电凝止血,对照组患者性术中采用缝合止血;观察并比较术后4周、12周两组患者促卵泡生长激素（FSH）、促黄体激素（LH）、雌二醇（E2）及窦状卵泡计数（Shape of sinus follicle count,AFC）,对比两组术后12周卵巢功能恢复情况。结果：术后4周两组患者FSH、LH水平较术前升高,E2及AFC水平较术前降低,差异均有统计学意义（P〈0.05）;术后12周对照组FSH、LH、E2及AFC水平与术前比较,差异无统计学意义（P〉0.05）,观察组患者FSH、LH水平较术前升高,E2及AFC水平较术前降低,且观察组患者FSH、LH水平高于对照组,E2及AFC水平低于对照组,差异均有统计学意义（P〈0.05）;术后12周,观察组患者出现排卵异常、经量过少及经期延长的发生率均高于对照组（P〈0.05）。结论：缝合止血在腹腔镜下卵巢囊肿剥除术止血对患者卵巢功能的损伤作用小于电凝止血,术后卵巢功能恢复快,临床上应当优选缝合止血,降低对卵巢功能的影响。

Objective： To explore the effect of suture and coagulation hemostasis on ovarian function after laparoscopic ovarian cyst removal. Methods： 78 cases of ovarian cysts undergone laparoscopic ovarian cyst removal in our hospital were selected as the research objects from May 2014 to December 2015, which were divided into observation group （41 cases） and control group （37 cases） according to the different ways of hemostasis. Observed and compared follicle stimulating growth hormone （FSH）, and luteinizing hormone （LH）, estradiol （E2） and antral follicle count （shape of sinus follicle count, AFC） of two groups after 4 weeks and 12 weeks operation. Compared two groups of ovarian function recovery after 12 weeks operation. Results： The levels of LH and FSH in two groups were significantly higher than that of before operation, the level of E2 and AFC were significantly lower than that of before operation after 4 week operation （P〈0.05）; The level ofFSH, LH, E2,AFC in control group had no significant difference in control group compared with before operation after 12 weeks operation;The levels of LH and FSH in observation groups was significantly higher than that of before operation, the level of E2 and AFC was significantly lower than that of before operationafter 12 week operation （P〈0.05）; The levels of LH and FSH in observation groups was significantly higher than that of control group and the level of E2 and AFC was significantly lower than that of control group after 12 week operation （P〈0.05）; The occurrence rate of abnormal ovulation, menstruation and menstruation in the observation group was higher than that of control group （P〈0.05） after 12 weeks operation. Conclusion： The effect of ovarian function of suture hemostasis is less than that of electric coagulation hemostasis for patients under gonel aparoscopic ovarian cyst stripping surgery, and the recovery ovarian function is fast; Suture hemostasis should be optimized and reduce the effect on ovarian function in clinical practice.