不同止血方法应用于卵巢子宫内膜异位囊肿腹腔镜剥离术中对卵巢功能的影响

Effects of Different Hemostatic Methods on Ovarian Function in Laparoscopic Excision of Ovarian Endometriotic Cysts

目的对比分析不同止血方法应用于卵巢子宫内膜异位囊肿腹腔镜剥离术中对卵巢功能的影响.方法选择2014年8月至2016年8月张家港市第三人民医院收治的行卵巢子宫内膜异位囊肿腹腔镜剥离术的患者96例,按数字随机表分为2组,各48例.对照组采用双极电凝止血法,观察组采用缝合止血法.对比分析2组手术情况、手术前后卵巢功能和自然妊娠率情况.结果观察组手术时间、术中出血量、疼痛程度评分与对照组相比,差异无统计学意义(P>0.05);观察组术后出血率、术后并发症发生率与对照组相比,差异无统计学意义(P>0.05);观察组术后FSH、E2、P水平低于对照组,LH、AFC和PSV指标高于对照组,差异有统计学意义(P<0.05);观察组自然妊娠率略高于对照组,差异无统计学意义(P>0.05).结论双极电凝止血法与缝合止血法应用于卵巢子宫内膜异位囊肿腹腔镜剥离术中均能够有效减少术后出血和并发症发生,提高自然妊娠率,但采用缝合止血法能尽可能保留患者正常卵巢组织,减轻对卵巢功能的影响,值得临床推广.

Objective To compare the effect of different hemostatic methods on ovarian function in laparoscopic excision of ovarian endometriotic cysts.Methods From August2014to August2016,96patients with laparoscopic excision of ovarian endometriosis were divided into two groups according to the number of random numbers.The control group was treated with bipolar coagulation hemostasis while the observation group was treated with suture hemostasis.The operation of the two groups was analyzed,and the ovarian function and natural pregnancy rate were analyzed before and after the operation.Results There was no significant difference in the operation time,intraoperative blood loss and pain score between the two groups(P>0.05).The incidence of postoperative bleeding rate and postoperative complication rate in the observation group were significantly lower than those in the control group(P<0.05).The levels of FSH,E2and P in the observation group were lower than those in the control group(P>0.05)while the LH,AFC and PSV indexes were significantly higher than those in the control group(P<0.05)The natural pregnancy rate was slightly higher than that of the control group and the difference was not statistically significant(P>0.05).Conclusion The use of bipolar coagulation and hemostasis in the treatment of laparoscopic ovarian endometriosis can effectively reduce postoperative bleeding and complications and improve the natural pregnancy rate,but the use of suture hemostasis is worth promoting for it can retain the normal ovarian tissue and reduce the impact on ovarian function as much as possible.