阴式卵巢囊肿剥除术对卵巢储备功能影响及临床疗效的对比分析

Analysis of the clinical effect of vaginal ovarian cystectomy on ovarian reserve

目的比较阴式卵巢囊肿剥除术和腹腔镜卵巢囊肿剥除术的临床疗效。方法 2013年6月—2016年6月在本院妇产科收治的卵巢囊肿病例中,根据微创手术方式(阴式手术和腹腔镜手术)分为观察组55例,对照组49例。2组患者平均年龄、体质量指数(BMI)、腹部手术史、囊肿直径、囊肿类型以及单双侧构成差异均无统计学意义;观察2组手术时间、术中出血量、住院费用和平均住院日以及手术前后卵巢储备功能情况。结果观察组手术时间[(46.9±18.4)min vs.(62.3±26.5)min]、住院费用[(8 165.3±951.8)元vs.(12 543.9±1 464.4)元]和平均住院日[(4.5±1.9)d vs.(6.8±2.3)d]少于对照组,差异均有统计学意义(P<0.05);2组手术前雌二醇(E2)、卵泡刺激素/黄体生成素(FSH/LH)、卵泡刺激素(FSH)和窦卵泡数差异无统计学意义;手术后观察组FSH/LH(1.4±0.4 vs.1.8±0.6)、FSH[(9.2±2.9)U/L vs.(13.6±4.3)U/L]低于对照组(P<0.05);观察组窦卵泡数多于对照组[(7.2±1.6)个vs.(6.0±1.3)个,P<0.05]。结论阴式卵巢囊肿剥除术对卵巢储备功能损伤小,适合育龄期女性患者,符合"价值医学"的要求。

Objective To compare the clinical efficacy between the vaginal ovarian cystectomy and the laparoscopicovarian cystectomy. Methods A total of 104 patients with ovarian cyst hospitalized in our hospital during June 2013-June2016 were selected and divided into observation group(vaginal ovarian cystectomy, n=55) and control group(laparoscopicovarian cystectomy, n=49). There were no significant differences in mean age, body mass index(BMI), abdominal surgical history, cyst diameter and cyst type between the two groups. The operation time, blood loss in operation, hospitalizationexpenses and average hospital stay were observed in the two groups. The ovarian reserve function before and after theoperation was also observed. Results The operation time [(46.9±18.4 min)], hospitalization cost [(8 165.3±951.8) yuan] andthe average length of hospital stay(4.5±1.9 days) were significantly less in the observation group than those of the controlgroup [(62.3±26.5) min], [(12 543.9±1 464.4) yuan] and [(6.8±2.3) days],(P<0.05). Before the operation, there were nosignificant differences in estradiol(E2), follicle stimulating hormone(FSH)/luteinizing(LH), FSH and antral follicle count(AFC) between the two groups. After the operation, the values of FSH/LH(1.4±0.4 vs. 1.8±0.6) and FSH [(9.2±2.9) U/L vs.(13.6±4.3) U/L] were significantly decreased in the observation group than those of the control group. The AFC(7.2±1.6 vs.6.0±1.3) was significantly more in the observation group than that of the control group(P<0.05). Conclusion The vaginalovarian cystectomy is of little damage to ovarian reserve function, which is suitable for women of child-bearing age andconforms to the requirement of 'value medicine'.