术中不同止血方式对生育期卵巢囊肿剥除术后卵巢功能的影响

Effect of different hemostatic methods on ovarian functions after ovarian cystectomy in growing period

目的比较腹腔镜下卵巢囊肿剥除术中使用不同止血方式对术后卵巢功能的影响,并探讨其可能的机制。方法选取2016年3~7月于我院行腹腔镜下卵巢囊肿剥除术的80例患者作为研究对象,将其随机分为对照组和试验组,每组各40例。对照组术中卵巢创面采用双极电凝止血,试验组术中卵巢创面采用缝合止血。比较两组患者术前、术后1、3、6个月的AFC及AMH水平。结果术后1个月,两组患者的AFC及AMH均低于术前,差异有统计学意义(P<0.01),试验组高于对照组,差异有统计学意义(P<0.05)。术后3个月,两组患者的AFC均高于本组术后1个月,但仍低于本组术前,差异有统计学意义(P<0.05),试验组高于对照组,差异有统计学意义(P<0.01)。术后6个月,试验组患者的AFC及AMH与术前比较,差异无统计学意义(P>0.05)。结论腹腔镜卵巢囊肿剥除术中采用缝合止血术能更好地保护患者卵巢功能,值得临床推广。

Objective To compare the effect of different hemostatic methods on ovarian functions after laparoscopic o- varian cystectomy,and to investigate the possible mechanism.Methods Altogether 80 cases of benign ovarian tumor pa- tients who underwent laparoscopic ovarian cystectomy in our hospital from March 2016 to July 2016 were selected as subjects and were randomly divided into control group and experiment group,40 cases in each group.The ovarian wound of control group was intra-operatively treated with bipolar coagulation hemostasis,while the ovarian wound of experi- ment group was treated with suture hemostasis.The AFC and AMH levels of the two groups were compared before surgery and 1,3,6 months after surgery.Results In the first month after surgery,the AFC and AMH in both groups were lower than before the surgery,and the differences were statistically significant （P〈0.01）.These indexes in the experimen- tal group were higher than those in the control group,and the differences were statistically significant （P〈0.05）.Three months after surgery,the AFC in two groups was higher than the first month after surgery,but still lower than before the surgery,the differences were statistically significant （P〈0.05）.These indexes in the experimental group were higher than those in the control group,and the differences were statistically significant （P〈0.01）.Six months after surgery,the AFC and AMH in the experimental group were compared before surgery,and the differences were not statistically significant （P〉0.05）.Conclusion Application of suture hemostasis in laparoscopic ovarian cystectomy can better protect the pa- tients＇ ovarian functions,which is worthy of clinical promotion.