不同术式治疗对卵巢囊肿患者卵巢功能、阴道菌群及性功能的影响

Effects of different surgical procedures on ovarian function, vaginal flora and sexual function in patients with ovarian cysts

目的探究不同术式治疗对卵巢囊肿患者卵巢功能、阴道菌群及性功能的影响。方法选取2013年1月至2018年1月在广东省东莞市东城医院治疗且术后病理报告证实良性病变的80例卵巢囊肿患者的临床资料作回顾性分析。按照妇科手术方式将80例患者分为A组(开腹手术)27例、B组(腹腔镜手术)28例、C组(阴式手术)25例。统计比较三组患者卵巢功能、阴道菌群、女性性功能评分和手术情况。结果术后1个月,A组、B组患者血清E2水平均有所下降,血清FSH、LH水平均有所上升(均P<0.05),C组患者血清E2、FSH、LH水平均无明显变化(均P>0.05);术后3个月,A组、B组患者血清E2、FSH、LH水平均恢复到术前水平(均P>0.05),C组患者血清E2、FSH、LH水平均无明显变化(均P>0.05);A组、B组和C组患者术后阴道菌群失调率分别为37.0%、39.3%和44.0%,其差异均无统计学意义(均P>0.05);A组、B组患者术后性功能评分与术前相比,其差异均无统计学意义(均P>0.05),C组患者术后性功能评分明显低于术前和A组、B组术后(均P<0.05);手术时间从少到多依次为C组、B组、A组,且三组手术时间差异均具有统计学意义(均P<0.05),C组患者首次排气时间明显短于A组患者(P<0.05)和B组患者(P<0.05),B组患者住院时间明显短于A组患者(P<0.05),C组患者住院时间明显短于A组患者(P<0.05)。结论不同术式均可以有效治疗卵巢囊肿,但每种手术方式均有适应症和优缺点,在临床治疗中,医生应当根据患者实际情况选择手术方式,帮助患者更好地恢复健康。

Objective To explore the effects of different surgical procedures on ovarian function, vaginal flora and sexual function in patients with ovarian cysts. Methods The clinical data of 80 patients with ovarian cysts who were treated in Dongguan Dongcheng Hospital and were confirmed as benign lesions by postoperative pathology from January 2013 to January 2018 were retrospectively analyzed. All patients were divided into group A(laparotomy, 27 cases), group B(laparoscopic surgery, 28 cases) and group C(vaginal surgery, 25 cases) according to gynecologic surgery methods. The ovarian function, vaginal flora, female sexual function score and operation conditions were compared statistically among the three groups. Results At 1 month after operation, serum E2 level in group A and group B was decreased while serum FSH and LH levels were increased(all P<0.05), and there was no significant change in the levels of serum E2, FSH and LH in group C(all P>0.05). At 3 months after operation, the levels of serum E2, FSH and LH in group A and group B returned to the preoperative level(all P>0.05), and there was no significant change in the levels of serum E2, FSH and LH in group C(all P>0.05). The imbalance rates of vaginal flora after operation in group A, group B and group C were 37.0%, 39.3% and 44.0% respectively, and the differences were not statistically significant(all P>0.05). There was no significant difference in postoperative sexual function score in group A and group B compared with that before operation(all P>0.05), and the postoperative sexual function score in group C was significantly lower than that before operation and that in group A and group B after operation(all P<0.05). The operative time were in turn, from the shortest to the longest, group C, group B and group A, and there was a significant difference in the operative time among the three groups(all P<0.05). The first exhaust time in group C was significantly shorter than that in group A(P<0.05) and group B(P<0.05). The hospital stay in group B was significantly shorter than that in group A(P<0.05), and the hospital stay in group C was significantly shorter than that in group A(P<0.05). Conclusions Different surgical procedures can effectively treat ovarian cysts, but each surgical procedure has indications, advantages and disadvantages. In clinical treatment, doctors should make an appropriate choice of surgical methods according to the actual situation of patients so as to help patients better restore health.