探讨腹腔镜卵巢子宫内膜异位囊肿水压剥除及缝合止血对卵巢储备功能的影响

Investigation on the effect of laparoscopic ovarian endometriosis cyst removal and suture hemostasis on ovarian reserve function

目的分析卵巢储备功能受到腹腔镜卵巢子宫内膜异位囊肿水压剥除及缝合止血治疗的影响。方法 99例卵巢子宫内膜异位囊肿患者,根据治疗方法不同分为实验组(50例)和对照组(49例)。实验组患者使用垂体后叶素水压分离缝合止血法,对照组使用直接剥离电凝止血法。比较两组窦卵泡数(AFC)、基础性激素水平[促卵泡成熟激素(FSH)、抗苗勒管激素(AMH)、雌二醇(E_2)]等指标。结果实验组术前、术后48 h、术后1个月、术后3个月FSH分别为(6.20±1.89)、(11.71±2.08)、(13.21±1.72)、(9.81±1.20)m IU/ml,对照组分别为(6.71±1.70)、(9.53±1.26)、(10.41±1.53)、(7.10±1.31)m IU/ml;实验组不同时间的AMH分别为(3.93±1.07)、(1.56±0.72)、(1.76±0.85)、(2.34±0.69)ng/ml,对照组分别为(3.95±1.05)、(2.30±1.06)、(2.35±0.75)、(3.34±0.91)ng/ml;实验组不同时间的E2分别为(128.61±25.60)、(91.27±20.27)、(89.21±21.31)、(102.21±23.49)pg/ml,对照组分别为(136.71±25.11)、(129.55±23.50)、(100.81±25.21)、(129.80±26.61)pg/ml;实验组不同时间的AFC分别为(5.50±1.31)、(4.62±1.76)、(4.24±1.82)、(3.55±2.05)个,对照组分别为(5.96±1.18)、(5.71±1.29)、(5.02±1.47)、(5.53±1.52)个。术前两组患者各指标对比差异无统计学意义(P>0.05),术后两组患者各指标均较术前有所改善,且实验组个指标改善水平优于对照组,差异有统计学意义(P<0.05)。结论腹腔镜卵巢子宫内膜异位囊肿水压剥除及缝合止血不会造成卵巢功能损害,临床中可以使用。

Objective To analyze the effect of laparoscopic ovarian endometriosis cyst removal and suture hemostasis on ovarian reserve function.Methods A total of99ovarian endometriosis cyst patients were divided by different treatment methods into experimental group(50cases)and control group(49cases).The experimental group received separation and hemostasis of pituitrin by water pressure suture,and the control group received direct stripping electrocoagulation hemostasis.Comparison were made on antral follicle count(AFC),basal sex hormone levels[follicle stimulating hormone(FSH),anti Mullerian hormone(AMH)and estradiol(E2)]in two groups.Results The experimental group had FSH before operation,postoperative48h,1month and3months respectively as(6.20±1.89),(11.71±2.08),(13.21±1.72)and(9.81±1.20)mIU/ml,which were respectively(6.71±1.70),(9.53±1.26),(10.41±1.53)and(7.10±1.31)mIU/ml in the control group.The experimental group had AMH at different times respectively as(3.93±1.07),(1.56±0.72),(1.76±0.85)and(2.34±0.69)ng/ml,which were respectively(3.95±1.05),(2.30±1.06),(2.35±0.75)and(3.34±0.91)ng/ml in the control group.The experimental group had E2at different times respectively as(128.61±25.60),(91.27±20.27),(89.21±21.31)and(102.21±23.49)pg/ml,which were respectively(136.71±25.11),(129.55±23.50),(100.81±25.21)and(129.80±26.61)pg/ml in the control group.The experimental group had AFC at different times respectively as(5.50±1.31),(4.62±1.76),(4.24±1.82)and(3.55±2.05)pieces,which were respectively(5.96±1.18),(5.71±1.29),(5.02±1.47)and(5.53±1.52)pieces in the control group.Before operation,both groups had no statistically significant difference in all indicators(P>0.05).After operation,both groups had improve indications than before treatment,an the experimental group had better improvement than the control group.Their difference was statistically significant(P<0.05).Conclusion Laparoscopic ovarian endometriosis cyst removal and suture hemostasis will not cause ovarian function damage,and can be used in clinic.