浅析腹腔镜卵巢瘤剥除术中三种止血方式对卵巢功能的影响

Impact of three types of hemostasis on ovarian function in laparoscopic ovarian tumor resection

目的研究腹腔镜卵巢瘤剥除术中三种止血方式对卵巢功能的影响。方法 94例单侧卵巢瘤患者为研究对象,均行腹腔镜卵巢瘤剥除术,根据术中使用止血方式的不同分为三组,双极电凝组(24例)、双极电凝+生理盐水冲洗组(36例)、镜下缝合组(34例)。术后对比三组患者的卵巢功能情况。结果 94例患者均顺利完成手术,无中转开腹,切口甲级愈合,无一例发生感染及并发症,术后3~5 d出院。术后三组患者均有不同程度的卵巢功能变化,双极电凝+生理盐水冲洗组和镜下缝合组卵泡刺激素、血流速度峰值、卵巢横切面最大直径比较,差异均无统计学意义(P>0.05)。双极电凝组卵巢储备功能下降明显,与双极电凝+生理盐水冲洗组和镜下缝合组比较,差异均有统计学意义(P<0.05)。结论腹腔镜下卵巢瘤剥除术使用双极电凝+生理盐水冲洗止血和镜下缝合止血的方式能够最大限度的降低卵巢功能受到的影响,双极电凝+生理盐水冲洗止血使用简便,推荐使用。

Objective To study the impact of three types of hemostasis on ovarian function inlaparoscopic ovarian tumor resection.Methods A total of94unilateral ovarian tumor patients as study subjectsall receiving laparoscopic ovarian tumor resection were divided by different hemostasis into three groups of bipolarcoagulation group(24cases),bipolar coagulation+saline flush group(36cases)and microscopic suture group(34cases).Ovarian function situation was compared after operation in three groups.Results All94patients hadsuccessful operation without conversing to laparotomy,and the incision healed up well.No case had infectionand complications,and they discharged in postoperative3~5d.After operation,three groups had different degreeof ovarian function changes,and bipolar coagulation+saline flush group and microscopic suture group had nostatistically significant difference in follicle-stimulating hormone,peak systolic velocity and maximum diameter ofthe ovary cross section(P>0.05).Bipolar coagulation group showed obviously decreased ovarian reserve function,and it had no statistically significant difference comparing with bipolar coagulation+saline flush group andmicroscopic suture group(P<0.05).Conclusion Both bipolar coagulation+saline flush and microscopic suturein laparoscopic ovarian tumor resection can minimize the effects on ovarian function,and bipolar coagulation+saline flush is more simple for hemostasis.So it is recommend to use.