腹腔镜下卵巢囊肿剔除术后对卵巢功能的影响

Effect of laparoscopic ovarian cyst removal on ovarian function

目的分析腹腔镜下卵巢囊肿剔除术不同止血方法对卵巢功能的影响,为卵巢囊肿患者手术方案制定提供参考。方法选取2016年7月至2017年7月在我院行腹腔镜卵巢囊肿剔除术治疗的84例患者作为研究对象,采用抽签的方式分为对照组和研究组,每组42例。两组患者均由同一组医护人员实施腹腔镜下卵巢囊肿剔除术,对照组术中采用电凝止血,研究组术中采用缝合止血。术后1个月、3个月、6个月、12个月随访患者卵巢功能相关指标:血清卵泡刺激素(FSH)、雌二醇(E2)、孕酮(P)、黄体生成激素(LH)、抗苗勒氏管激素(AMH)水平,并与术前比较,再行组间比较。收集两组患者术后并发症情况并比较,术后1年内囊肿复发率比较。结果两组患者术前FSH、LH、E2、P、AMH比较差异无统计学意义(P>0.05)。术后1个月、3个月两组患者FSH、LH均较术前明显升高,AMH、E2均较术前明显降低,但组间比较差异无统计学意义(P>0.05)。术后6个月、12个月,两组患者FSH、LH逐渐下降,且研究低于对照组,术后12个月研究组与术前比较差异无统计学意义(P>0.05),而对照组仍然高于术前;术后6个月、12个月两组患者AMH、E2逐渐上升,且研究高于对照组,差异有统计学意义(P<0.05),术后12个月研究与术前比较差异无统计学意义(P>0.05)。两组患者术后并发症率比较、囊肿复发率比较差异均无统计学意义(P>0.05)。结论腹腔镜下卵巢囊肿剔除术患者的近期卵巢功能会有所下降,但术中采用缝合止血较电凝止血可更快恢复卵巢功能,且不增加并发症和复发率。

Objective To analyze the influence of different hemostasis methods in laparoscopic ovarian cyst removal on ovarian function, and to provide reference for the formulation of surgical plans for patients with ovarian cyst. Methods 84 patients who underwent laparoscopic ovarian cyst removal in our hospital from July 2016 to July 2017 were selected as the study subjects, and were divided into control group and observation group by lottery, with 42 cases in each group. Both groups of patients were treated with laparoscopic ovarian cyst removal by the same group of medical staff, the control group was treated with electrocoagulation and hemostasis, and the study group was treated with suture and hemostasis. Patients were followed up at 1, 3, 6 and 12 months after surgery for ovarian function related indicators which were the serum follicle stimulating hormone (FSH), estradiol (E2), progesterone (P), luteinizing hormone (LH), and AMH level. Complication of the two groups were collected and compared, and the recurrence rate of cyst within 1 year after surgery was compared. Results There were no statistical significantly differences in preoperative FSH, LH, E2, P and AMH between the two groups ( P >0.05). FSH and LH were significantly increased and AMH and E2 were significantly decreased in both groups 1 month and 3 months after surgery ( P <0.05), but there was no statistical significantly differences between the two groups ( P >0.05). At 6 and 12 months after surgery, FSH and LH in the two groups decreased gradually, and the study was lower than that in the control group ( P <0.05). There were no statistical significantly differences between the study group and the preoperative group at 12 months after surgery ( P >0.05), while the control group was still higher than that before surgery ( P <0.05). AMH and E2 gradually increased in the two groups at 6 months and 12 months after surgery, and the study was higher than that in the control group ( P <0.05). There were no statistical significantly differences between the study at 12 months after surgery and the preoperative comparison ( P >0.05). There were no statistical significantly differences in postoperative complication rate and cyst recurrence rate between the two groups ( P >0.05). Conclusion The ovarian function of patients undergoing laparoscopic cystectomy of ovary will decrease in the near future, but intraoperative suture hemostasis can restore ovarian function faster than electrocoagulation hemostasis, without increasing complications and recurrence rate.