经阴道超声引导穿刺介入治疗对卵巢巧克力囊肿卵巢储备功能的影响

Effect of transvaginal ultrasound-guided interventional therapy on ovarian reserve function in ovarian chocolate cyst

目的探讨经阴道超声引导穿刺介入治疗对卵巢巧克力囊肿的卵巢储备功能的影响。方法选择2015年4月~2017年12月于本院诊治卵巢巧克力囊肿患者60例为研究对象,按照随机数字表法分为介入组和腹腔镜组,各30例。腹腔镜组给予腹腔镜巧克力囊肿摘除术治疗,介入组给予经阴道超声引导巧克力囊肿穿刺无水乙醇介入术治疗,比较两组治疗效果、复发率和卵巢储备功能情况。结果两组总有效率比较,差异无统计学意义(P>0.05),介入组复发率高于腹腔镜组,差异有统计学意义(P<0.05);术后1个月介入组E2、AFC均低于术前,FSH高于术前(P<0.05),术前3个月的介入组E2、AFC、LH、FSH与术前差异均无统计学意义(P>0.05),术前1个月、3个月腹腔镜组E2、AFC均低于术前及介入组,LH、FSH均高于术前及介入组,差异有统计学意义(P<0.05)。介入组痛经术后缓解率低于腹腔镜组,差异有统计学意义(P<0.05)。介入组妊娠率低于腹腔镜组,差异有统计学意义(P<0.05)。结论经阴道超声引导穿刺介入治疗卵巢巧克力囊肿效果显著,对卵巢的储备功能影响小,可作为临床治疗卵巢巧克力囊肿的一种较好选择方法。

Objective To investigate the effect of transvaginal ultrasound-guided puncture and interventional therapy on ovarian reserve function of ovarian chocolate cyst. Methods Sixty cases with ovarian chocolate cyst were selected from April 2015 to December 2017 in our hospital.They were divided into interventional group and laparoscopic group according to the random number table method,30 cases in each group.Laparoscopic chocolate cyst excision was performed in the laparoscopic group,and transvaginal ultrasound guided chocolate cyst puncture with absolute alcohol intervention was performed in the intervention group.The therapeutic effect,recurrence rate and ovarian reserve function were compared between the two groups. Results There was no significant difference in the total effective rate between the two groups（P〈0.05）.The recurrence rate of intervention group was higher than that of laparoscopy group, the difference was statistically significant（P〈0.05）.E2 and AFC in intervention group were lower than those before operation 1 months after operation, and FSH was higher than that before operation（P〈0.05）.There was no significant difference in E2, AFC, LH and FSH between 3 months before operation and preoperative group（P〈0.05）.E2 and AFC in laparoscopic group were lower than those in preoperative and interventional groups at 1 month and 3 months before operation, LH and FSH were higher than those in preoperative and interventional groups（P〈0.05）;The remission rate of dysmenorrhea in intervention group was lower than that in laparoscopy group（P〈0.05）.The pregnancy rate of intervention group was lower than that of laparoscopy group, the difference was statistically significant（P〈0.05）. Conclusion Transvaginal ultrasound-guided puncture and interventional treatment of ovarian chocolate cyst has a significant effect and little effect on ovarian reserve function. It can be used as a better choice for clinical treatment of ovarian chocolate cyst.