腹腔镜卵巢子宫内膜异位囊肿剥除术中150例缝合止血联合不同电凝治疗的疗效及预后分析

Therapeutic effect and prognosis of 150 patients received laparoscopic ovarian endometriosis cyst stripping surgery combined with different coagulation therapy

目的:探讨腹腔镜卵巢子宫内膜异位囊肿剥除术中150例缝合止血联合不同电凝治疗的疗效及预后分析。方法:选取2015年1月至2015年12月在汉阳医院妇产科接受治疗的卵巢子宫内膜异位囊肿患者150例作为本研究对象。所有患者全部进行常规性腹腔镜卵巢子宫内膜异位囊肿切除术,术中按照不同的止血方式分为镜下缝合止血组、双极电凝组和单极电凝组。观察比较三组患者止血方式术后1、3、6、12个月的卵泡刺激素(follicle stimulating hormone,FSH)和窦状卵泡计数(sinusoidal follicle count,AFC)水平,并在术后12个月调查患者的自然妊娠情况。结果:三组患者入院时FSH水平表达差异无统计学意义(P>0.05);术后1、3、6、12个月三组患者FSH水平与术前比较有所升高,差异具有统计学意义(P<0.05);三组患者入院时AFC水平差异无统计学意义(P>0.05);术后3、6、12个月镜下缝合止血组患者的AFC水平高于单极电凝组和双极电凝组,差异具有统计学意义(P<0.05);术后12个月检测患者的自然妊娠率,镜下缝合止血组患者的自然妊娠率达到60.00%,明显高于单极电凝组(16.00%)和双极电凝组(18.00%),差异具有统计学意义(P<0.05);术后3个月单极电凝组、双极电凝组患者的窦卵泡数明显低于术前,镜下缝合止血组计数水平高于单极电极组和双极电凝组,差异具有统计学意义(P<0.05)。结论:腹腔镜下卵巢囊肿剥除术镜下缝合止血对患者的卵巢功能影响小,而单级和双极电凝止血对患者的卵巢功能均存在不同程度的不良影响。

Objective： To investigate the efficacy and prognosis of 150 patients received laparoscopic ovarian endometriosis cyst stripping surgery combined with different coagulation therapy. Methods： 150 patients with endometrial cysts treated in the Obstetrics and Gynecology Department of Hanyang Hospital from January 2015 to December2015 were selected as the study subjects. All patients underwent conventional laparoscopic ovarian endometriosis cystectomy and were divided into subcutaneous suture hemostasis group,bipolar coagulation group and unipolar coagulation group. The levels of Follicle Stimulating Hormone（ FSH） and Sinusoidal follicle count（ AFC） in patients at 1,3,6 and 12 months postoperative hemostasis,and natural pregnancy rate at 12 months after surgery were compared.Results： There was no significant difference in the expression of FSH levels between the three groups at admission（ P 〈 0. 05）. The levels of FSH in the three groups at 1,3,6 and 12 months after surgery were significantly higher than those before surgery,with statistically significant difference（ P〉0. 05）. There was no statistically significant difference in AFC levels at admission between the three groups（ P 〈 0. 05）. AFC levels in the patients in subcutaneous suture hemostasis group at 3,6 and 12 months after surgery were higher than those in the unipolar coagulation group and bipolar coagulation group,with statistically significant difference（ P 〈 0. 05）. The natural pregnancy rate in the subcutaneous suture hemostasis group at 12 months after surgery was 60. 00%,significantly higher than that of unipolar coagulation group（ 16. 00%） and bipolar coagulation group（ 18. 00%）,with statistically significant differences（ P 〈 0. 05）. The number of antral follicles in patients of unipolar coagulation group and bipolar coagulation group at 3 months after operation was significantly smaller than those before surgery,and that of the subcutaneous suture hemostasis group was larger than the other two groups,with statistically significant difference（ P 〈 0. 05）. Conclusions：Subcutaneous suture hemostasis in laparoscopic ovarian endometriosis cyst stripping surgery has little effect on ovarian function,while unipolar coagulation and bipolar coagulation have certain effect on the ovarian function.