腹腔镜剔除术与传统手术对卵巢子宫内膜异位囊肿患者卵巢储备及生育功能的影响

Comparison of the Effect of Laparoscopic Ovarian Endometriosis Cystectomy and Traditional Surgery on the Ovarian Reserve and Fertility Function

目的:对比分析腹腔镜囊肿剔除术与传统手术对卵巢子宫内膜异位囊肿患者卵巢储备功能及生育功能的影响。方法:选择我院诊治的卵巢子宫内膜异位囊肿患者100例,随机分为观察组与对照组,每组各50例。对照组采用传统手术治疗,即囊肿抽吸加囊壁电凝术,观察组采用腹腔镜卵巢子宫内膜异位囊肿剔除术进行治疗,两组在手术后进行促排卵治疗。观察和比较两组的窦卵泡数、血清促卵泡生成素水平、给予促性腺激素释放激素激动剂支数、给予促性腺激素释放激素激动剂天数以及HCG注射日血清雌二醇水平,并采用超声检测两组的好胚数、卵子数、冷冻数、妊娠率、移植数以及分娩率。结果:观察组的窦卵泡数以及HCG注射日血清雌二醇水平明显高于对照组(P<0.05),血清促卵泡素水平以及给予促性腺激素释放激素激动剂的支数明显低于对照组(P<0.05)。此外,观察组的好胚数、卵子数、冷冻数、妊娠率、移植数以及分娩率均较对照组明显升高(P<0.05)。结论:相比于传统手术,腹腔镜卵巢剔除术对患者卵巢储备功能和生育功能的影响较小,安全性较高,不影响患者的再次妊娠及分娩。

Objective： To compare the effects of laparoscopic ovarian endometriosis cystectomy and traditional surgery on the ovarian reserve and fertility function. Methods： 100 cases of ovarian endometriosis cysts treated in our hospital were selected and randomly divided into the observation group and the control group with 50 cases in each group. The control group was treated with traditional surgery （cysts suction plus capsule wall electrocoagulation）. The observation group was treated with laparoscopic ovarian endometriosis cystectomy. Both groups were treated with ovulation after surgery. The ovarian function of both groups were observed： the number of antral follicles, the level of serum follicle-stimulating hormone, the number of gonadotropin-releasing hormone agonists, the number of days of gonadotropin-releasing hormone agonists, and the serum estradiol level. Ultrasound was used to detect and observe the fertility function of both groups： good embryo number, egg number, freezing number, pregnancy rate, transplant number and delivery rate. Results： The number of sinus follicles and the serum estradiol level on the HCG injection in the observation group were significantly higher than those of the control group （P〈0.05）, the serum follicle stimulating hormone levels and the number of gonadotropin-releasing hormone agonists in the observation group were significantly lower than those of the control group （P〈0.05）. The number good embryo number, egg number, freezing number, pregnancy rate, transplant number and delivery rate were significantly higher than those in the control group（P〈0.05）. Conclusions： Compared with traditional surgery, laparoscopic ovarian endometriosis cystectomy has limited effect on the ovarian reserve and fertility function of patients, which can not cause adverse effects on the patients＇ re-pregnancy and childbirth.