腹腔镜下卵巢手术采用不同缝合方法对卵巢分泌性激素的影响

Effects of different sutures on ovarian sexual hormones secretion in laparoscopic operation

目的探讨腹腔镜下卵巢巧克力囊肿剥除术中残留卵巢皮质采用2种不同的缝合止血方法对术后卵巢分泌性激素的影响。方法选取收治的单侧卵巢巧克力囊肿患者60例施行腹腔镜下囊肿剥除手术,应用随机分组法分为两组,A组30例术中创面采用基底部连续U型缝合法,B组30例采用囊外连续缝合法。对所有患者术前、术后1个月、术后3个月分别抽外周静脉血,采用化学发光法检测卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_2),对两组以上指标进行比较,以评判不同缝合方法对卵巢分泌性激素的影响。结果两组患者术后1个月E_2水平较术前明显降低,FSH、LH较术前明显升高,与术前相比差异有统计学意义(P<0.05);术后3个月,E_2水平较术前稍升高,FSH、LH较术前稍降低,但与术前比较差异无统计学意义(P>0.05)。术后1个月,B组对卵巢激素的影响均大于A组,差异有统计学意义(P<0.05)。结论腹腔镜下卵巢子宫内膜异位囊肿剔除术中无论采用基底部连续U型缝合或囊外连续缝合法止血法,在术后3个月内均对卵巢分泌性激素造成影响,尤以囊外连续缝合法对卵巢功能的影响更为显著。所有患者卵巢分泌性激素的功能在术后3个月内可恢复正常。

Objective To explore the effects of different sutures on ovarian sexual hormones secretion in laparoscopic operation. Methods Sixty patients with unilateral ovarian cyst who underwent laparoscopic cystectomy were randomly divided into two groups： hilum continuous U style suture group（ group A） and cortex continuous suture group（ group B）,with 30 cases in each group. The patients in group A received hilum continuous U style suture for hemostasis,and the patients in group B received cortex continuous suture for hemostasis. The serum levels of follicle stimulating hormone（ FSH）,luteinizing hormone（ LH）,estradiol（ E2） were detected respectively before the operations and at the first and the third month after the operation. Results In the two groups,compared with those before the operation,the level of E2 reduced significantly,and the levels of FSH and LH increased the first month after the operation（ P〈0. 05）; the level of E2 reduced slightly,the levels of FSH and LH increased slightly at the third month after the operation with no significant differences（ P〉0. 05）; group B had more influence on the ovarian sexual hormone secretion than group A（ P〈0. 05）. Conclusion Both of the two hemostatic methods have effects on sexual hormones secretion in laparoscopic cystectomy for ovarian endometriotic cyst. In most of the patients,the ovarian sexual hormone secretion can be recovered to the normal level basically within 3 months after the operation.