腹腔镜卵巢囊肿切除术对卵巢囊肿患者术后卵巢功能及生活质量的影响

Effect of Laparoscopic Ovarian Cystectomy on Postoperative Ovarian Function and Quality of Life in Patients with Ovarian Cysts

目的:探讨腹腔镜卵巢囊肿切除术(LOC)对卵巢囊肿(OC)患者术后卵巢功能及生活质量的影响。方法:选取2016年1月-2019年4月在本院就诊并诊断为OC的130例患者为研究对象,根据手术途径不同分为腹腔镜组(n=65,采用LOC治疗)和开腹组(n=65,采用传统开腹手术治疗)。比较两组手术相关指标;术前及术后3个月,比较两组性激素水平、卵巢形态学参数、性生活质量量表(FSFI)评分及SF-36生活质量量表评分[躯体生理健康总评分(PCS)和精神心理健康总评分(MCS)]。结果:腹腔镜组术中失血量明显低于开腹组,且手术时间、术后下床时间及术后住院时间均明显短于开腹组(P<0.05)。两组术前血清雌二醇(E2)、黄体生成素(LH)及卵泡刺激素(FSH)水平比较,差异均无统计学意义(P>0.05);两组术后3个月血清E2水平均明显低于术前,LH和FSH水平均明显高于术前(P<0.05);术后3个月,腹腔镜组血清E2水平明显高于开腹组,LH和FSH水平均明显低于开腹组(P<0.05)。两组术前卵巢体积(OV)及卵巢窦卵泡数(AFC)比较,差异均无统计学意义(P>0.05);两组术后3个月OV与AFC均明显低于术前(P<0.05);术后3个月,腹腔镜组OV与AFC均明显高于开腹组(P<0.05)。两组术前FSFI、PCS和MCS评分比较,差异均无统计学意义(P>0.05);两组术后3个月FSFI、PCS和MCS评分均明显高于术前(P<0.05);术后3个月,腹腔镜组FSFI、SPCS和MCS评分均明显均高于开腹组(P<0.05)。结论:与传统开腹手术比较,LOC治疗OC能够明显减少术中失血量,缩短手术时间,促进术后恢复,明显改善生活质量,同时对患者早期的卵巢功能产生的影响相对较小。

Objective:To investigate the effect of laparoscopic ovarian cystectomy(LOC)on postoperative ovarian function and quality of life in patients with ovarian cyst(OC).Method:From January 2016 to April 2019,130 patients admitted to our hospital and diagnosed with OC were selected as the study subjects.According to different surgical approaches,they were divided into the laparoscopic group(n=65,treated with LOC)and the laparotomy group(n=65,treated with traditional open operation).The surgical indicators of the two groups were compared.Before and 3 months after surgery,the serum sex hormone levels,ovarian morphology parameters,sexual quality of life scale(FSFI),SF-36 quality of life scale[physical component summary(PCS)and mental component summary(MCS)]score were compared between the two groups.Result:The intraoperative blood loss in the laparoscopic group was significantly lower than that in the laparotomy group,and the operative time,postoperative time out of bed and postoperative hospital stay were significantly lower than those in the laparotomy group(P<0.05).There were no statistically significant differences in serum estradiol(E2),luteinizing hormone(LH)and follicle stimulating hormone(FSH)levels between the two groups before surgery(P>0.05).Serum E2 level of two groups were significantly lower than those before surgery,and LH and FSH levels were significantly higher than those before surgery(P<0.05).3 months after surgery,the serum E2 level of the laparoscopic group was significantly higher than that of the laparotomy group,and the LH and FSH levels were significantly lower than those of the laparotomy group(P<0.05).There were no significant differences in preoperative ovarian volume(OV)and antral follicle count(AFC)between the two groups(P>0.05).3 months after surgery,the OV and AFC of two groups were significantly lower than those before surgery(P<0.05).3 months after surgery,the OV and AFC of the laparoscopy group were significantly higher than those of the laparotomy group(P<0.05).There were no significant differences in preoperative FSFI,PCS and MCS score between the two groups(P>0.05).FSFI,3 months after surgery,PCS and MCS score of two groups were significantly higher than those before surgery(P<0.05).3 months after surgery,the FSFI,PCS and MCS score in the laparoscopic group were significantly higher than those in the laparotomy group(P<0.05).Conclusion:Compared with traditional laparotomy surgery,LOC treatment of OC can significantly reduce intraoperative blood loss,shorten the operation time and promote postoperative recovery and can significantly improve the quality of life of patients.Meanwhile,it has relatively small impact on the early ovarian function of patients.