腹腔镜卵巢囊肿剥除术中的两种止血方式对患者卵巢储备功能的影响

Effects of Two Different Hemostasis Methods on Ovarian Reserve Function in Patients Undergoing Laparoscopic Ovarian Cystectomy

目的:探讨行卵巢囊肿剥除术中2种止血方式对患者卵巢储备功能的影响。方法:120例接受卵巢囊肿剔除术的卵巢囊肿患者,根据术中使用止血方式均分为电凝组及缝合组;比较2组患者手术时间、术中出血量、卵巢功能早衰的发生率,采用酶联免疫吸附法(ELISA)检测术前及术后6个月时2组患者血清雌二醇(E2)、促卵泡激素(FSH)及促黄体生成素(LH)水平;观察2组患者术后6个月卵泡刺激素、血流速度峰值及卵巢横切面最大直径等卵巢储备功能恢复情况,术后1月和6月随访两组患者月经恢复情况。结果:缝合组手术时间显著长于电凝组、术中出血量显著多于电凝组,差异有统计学意义(P<0.05);2组术后卵巢功能早衰发生率比较,差异无统计学意义(P>0.05);2组患者术前E2、FSH及LH水平比较,差异无统计学意义(P>0.05);术后6个月时,缝合组E2水平显著高于电凝组,FSH及LH水平显著低于电凝组,差异均有统计学意义(P<0.05);缝合组卵巢储备功能指标恢复的患者比例高于电凝组,差异均有统计学意义(P<0.05);术后1个月及6个月时,缝合组患者月经总异常比例显著低于电凝组,差异均有统计学意义(P<0.05)。结论:缝合止血对患者激素水平、卵巢功能等方面的影响相对较小。

Objective:To explore the effect of two different hemostasis methods on ovarian reserve function in patients undergoing ovarian cystectomy.Methods:A total of 120 patients with ovarian cysts who underwent ovarian cystectomy were divided into electrocoagulation group and suture group according to the method of hemostasis during operation.The incidence of operation time,intraoperative bleeding volume,and premature ovarian failure were compared between the two groups.The serum hormone estradiol(E2),follicle stimulating hormone(FSH)and luteinizing hormone(LH)were measured by enzyme-linked immunosorbent assay(ELISA)before and 6 months after surgery.To observe the two groups'ovarian reserve function recovery of follicle stimulating hormone,peak blood flow velocity and maximum diameter of ovary transverse section after 6 months of operation.The menstrual recovery of the two groups was followed up after 1 month or 6 months.Results:Operation time in the suture group was significantly longer than electrocoagulation group,and the intraoperative bleeding volume in the suture group was more than that of the electrocoagulation group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of premature ovarian failure between the two groups(P>0.05).And no significant differences in E2,FSH and LH levels between the two groups(P>0.05).The level of E2 in the suture group was significantly higher than electrocoagulation group,and the levels of FSH and LH were significantly lower than electrocoagulation group(P<0.05)after operation for 6 months.The proportion of patients with ovarian reserve function recovery in the suture group was higher than electrocoagulation group,with statistically significant(P<0.05).At 1 month and 6 months after operation,the proportion of total abnormal menstruation in the suture group was obviously lower than electrocoagulation group,and the difference was statistically significant(P<0.05).Conclusion:The effect of suture and hemostasis on patients'hormone levels and ovarian function is relatively small.