腹腔镜卵巢囊肿剔除术对女性卵巢储备功能的影响

Effect of Laparoscopic Ovarian Cyst Removal on Ovarian Reserve Function in Female Patients

【目的】探讨腹腔镜下卵巢囊肿剔除术治疗子宫内膜异位囊肿对女性卵巢储备功能的影响。【方法】选取2013年4月至2015年3月在本院妇产科诊治的84例子宫内膜异位囊肿患者为研究对象，根据临床资料中患者手术方式分为观察组和对照组，对照组采用腹腔镜下囊肿切开放液术治疗，观察组采用腹腔镜卵巢囊肿剔除术，术后两组患者均给予促性腺激素激动剂（GnRH—a）治疗。观察并记录两组术前、术后6半年卵巢功能指标：血清卵泡刺激素（FSH）、黄体生成素（LH）、雌二醇（E2）的水平、基础卵泡数量、卵巢体积变化。比较两组复发率和月经、术后1年成功再妊娠情况。【结果】术后半年，两组LH和E2指标较术前显著下降，观察组LH和E2指标明显低于对照组（P〈0．05），术后半年两组FSH指标无明显改变（P〉0．05）；两组基础卵泡数量和卵巢平均体积较术前明显降低（P〈0．05）。两组患者术前和术后1年经期时间和月经周期比较差异无统计学意义（P〉0．05）。观察组术后1年妊娠率显著高于对照组，而复发率明显低于对照组，其差异具有统计学意义（P〈0．05）。【结论】行腹腔镜卵巢囊肿剔除术患者术后短期内卵巢储备功能受到一定影响，与传统开腹手术相比，腹腔镜卵巢囊肿剔除术在患者妊娠率、术后恢复及复发率方面仍然具有明显优势。

[Objective]To investigate the effect of laparoscopic ovarian cystectomy on ovarian reserve function in women with endometriosis.[Methods]Eighty-four patients with endometriosis cysts who were admitted to the obstetrics and gynecology department in our hospital between from April 2013 and to March 2015 were selected as the study subjects and were randomized into the observation group （ n =42） and the control group （ n =42） according to the order of admission. The control group was treated with laparoseopic open reduction of cyst, and the observation group was treated with laparoscopic ovarian cyst removal. All patients were treated with gonadotropin releasing hormone （GnRH-a） after operation. The changes of ovarian function indexes such as serum follicle stim- ulating hormone （FSH）, luteinizing hormone （LH） and estrogen （E2） levels, basic number of follicles and ovari- an volume in the two groups were recorded before operation and at 6 months after operation. The status of fertili- ty, including the rate of successful re-pregnancy and recurrence rate in 1 year after operation and menstruation were compared between the two groups. [Results] At six months after operation, levels of LH and E2 were signif- icantly lower than those before operation, and the levels LH and E2 in observation group were significantly lower than those in control group （ P ~0.05）. There were no significant changes of FSH at 6 months after operation （ P 〉0.05） ; The basic number of follicles and aveareg ovarian volume were significantly lower than those before oper- ation （ P 〈0.05）. There was no significant difference in menstrual period and menstrual cycle between the two groups before operation and at 1 year after operation （ P 〉0.05）. The pregnancy rate of observation group in 1 year after operation was significantly higher than that of control group while the recurrence rate was significantly lower than that in the control group （ P 〈0.05）. [Conclusion]The ovarian reserve function is affected in a short time after laparoseopic ovarian cystectomy, Compared with traditional laparotomy, laparoscopic ovarian cystectomy still has obvious advantages in terms of pregnancy rate, postoperative recovery and recurrence rate.