腹腔镜下卵巢良性囊肿剥除术中不同止血方法对术后卵巢功能的影响

Effect of different hemostatic methods on ovarian function after laparoscopic exfoliation of ovarian benign cysts

目的探讨腹腔镜下卵巢良性囊肿剥除术中不同止血方法对患者术后卵巢功能的影响。方法行腹腔镜下卵巢囊肿剥除术120例,分别采用镜下缝合止血(研究组,60例)或双极电凝止血(对照组,60例)。比较术前、术后3个月和6个月两组患者抗苗勒氏管激素(AMH)、卵泡雌激素(FSH)、黄体生成素(LH)和雌二醇(E2)水平以及卵巢窦卵泡数量。记录术后月经、出现盗汗和受孕情况。结果与术前比较,对照组患者术后3个月和6个月E2和AMH水平和窦卵泡数量降低,FSH和LH水平升高(P<0.05)。与术前比较,研究组术后3个月E2和AMH水平降低,FSH和LH水平升高(P<0.05),术后6个月E2、AMH、FSH和LH水平以及窦卵泡数量与术前比较无统计学差异(P>0.05)。两组患者术后月经周期规律和受孕情况比较无统计学差异(P>0.05)。研究组术后月经量减少和发生盗汗例数均少于对照组(P<0.05)。结论腹腔镜下卵巢良性囊肿剥除术中采用镜下缝合止血方法较双极电凝止血方法能更好的保护患者卵巢功能。

Objective To investigate the effect of different hemostatic methods on ovarian function after laparoscopic exfoliation of benign ovarian cysts.Methods Of 120 cases undergoing laparoscopic exfoliation of ovarian cysts,the hemostasis was performed by suturing under laparoscope(group A,60 cases)or bipolar electrocoagulation(group B,60 cases).The levels of anti-Mullerian hormone(AMH),follicle-estrogen(FSH),luteinizing hormone(LH)and estradiol(E2)and the number of follicles in ovarian sinus were compared between two groups before and 3 months and 6 months after operation.Postoperative menstruation,night sweating and conception were recorded.Results Compared to before,the levels of E2 and AMH and the number of antral follicles were decreased,while the levels of FSH and LH were increased 3 and 6 months after operation in group B(P<0.05).Compared to before,the levels of E2 and AMH were lower,but the levels of FSH and LH were higher 3 months after operation(P<0.05),while there were no significant differences in the levels of E2,AMH,FSH and LH and the number of sinus follicles 6 months after operation in group A(P>0.05).There were no significant differences in the postoperative menstruation and conception in both groups(P>0.05).The number of postoperative menstruation decrease and night sweating was lower in group A than that in group B(P<0.05).Conclusion For hemostasis during laparoscopic exfoliation of benign ovarian cysts,suturing under laparoscope is better than bipolar electrocoagulation in protecting the ovarian function.