经脐单孔腹腔镜治疗卵巢囊肿术中采用不同止血方法对卵巢功能影响的研究

Effect of Different Hemostasis on Ovarian Function in Transumbilical Single Hole Laparoscopic Treatment of Ovarian Cysts

目的:探讨经脐单孔腹腔镜卵巢囊肿剔除术中采用不同止血方法对卵巢功能的影响。方法:选取2018年1-10月在笔者所在医院接受经脐单孔腹腔镜卵巢囊肿剔除术的80例患者,根据止血方式分为电凝止血组(40例)和缝合止血组(40例)。比较两组术中出血情况及出血量、术前及术后月经恢复、卵巢激素水平的变化。结果:电凝止血组平均手术时间及平均出血量少于缝合止血组,差异有统计学意义(P<0.05),两组平均住院时间差异无统计学意义(P>0.05)。术后3个月随访,两组术后1个月和3个月的月经恢复情况差异无统计学意义(P>0.05);两组术前雌二醇(E2)、卵泡刺激素(FSH)、促黄体生成素(LH)等激素水平差异均无统计学意义(P>0.05);两组术前卵巢激素水平(E2、FSH、LH)和术后的1、3个月相比差异均有统计学意义(P<0.05),而且两组术后第1个月卵巢激素比较,缝合止血组优于电凝止血组,差异有统计学意义(P<0.05)。结论:术中采用镜下缝合与电凝止血均能有效止血,但镜下缝合止血对术后患者月经恢复及卵巢近期功能影响更小,更推荐于育龄女性。

Objective:To investigate the effect of different hemostasis on ovarian function in transumbilical single hole laparoscopic treatment of ovarian cysts.Method:Eighty patients who underwent transumbilical single hole laparoscopic ovarian cyst removal in our hospital from January to October of 2018 were selected and divided into electrocoagulation hemostasis group(40 cases)and suture hemostasis group(40 cases)according to the way of hemostasis.The intraoperative hemorrhage and bleeding volume,menstrual recovery,hormone levels were compared between the two groups.Result:The average operation time and blood loss between in the electrocoagulation hemostasis group were shorter than those in the suture hemostasis group,there were significant differences(P<0.05),and no significant difference in the average length of stay between the two groups(P>0.05).After 3 months follow-up visit,there was no significant difference in menstrual recovery between the two groups at 1 and 3 months(P>0.05).There were no significant differences in preoperative estradiol(E2),follicle stimulating hormone(FSH),luteinizing hormone(LH)levels between the two groups(P>0.05).There were statistical differences of ovarian hormone levels(E2,FSH,LH)in preoperative compared to 1 month and 3 months after operation between the two groups(P<0.05),and the ovarian hormones in the suture hemostasis group were better than those in the electrocoagulation hemostasis group,there were significant differences(P<0.05).Conclusion:Both endoscopic suture and electrocoagulation hemostasis can effectively stop bleeding during operation,but the effect of endoscopic suture hemostasis on menstrual recovery and ovarian function is less.It is recommended for women of childbearing age.