探讨卵巢巧克力囊肿腹腔镜手术时机的选择

Study on the Timing of Laparoscopic Surgery for Chocolate Cyst of Ovary

目的:研究探讨在卵巢巧克力囊肿患者人群中选择腹腔镜手术治疗的恰当时机。方法:随机抽选2017年3月~2019年4月在某院接受腹腔镜手术治疗的卵巢巧克力囊肿患者资料共计150例,分为观察组和对照组,每组75例。观察组中卵巢巧克力囊肿直径3~5cm,对照组中囊肿直径5~10cm,两组观察指标:(1)手术时间、出血量、rAFS评分;(2)术后1、6、12个月卵巢功能(FSH、LH、E2、AMH)的变化情况;(3)术后1年内妊娠率及复发率。结果:(1)观察组手术时间、出血量、rAFS评分均低于对照组(P<0.05);(2)观察组术后1、6、12个月卵巢功能与术前比较有轻微下降,无明显统计学差异(P>0.05);对照组术后1、6、12个月卵巢功能较术前有所下降(P<0.05);观察组术后对卵巢功能的影响与小于对照组(P<0.05);(3)观察组术后1年内妊娠率高于对照组(P<0.05),复发率却低于对照组(P<0.05)。结论:在卵巢巧克力囊肿患者人群中,尤其是囊肿中等大小(3~5cm)合并不孕患者,此时选择腹腔镜手术治疗风险较小,临床获益更大。

Objective:To study the appropriate time of laparoscopic surgery in patients with ovarian chocolate cyst.Methods:A total of 150 patients with ovarian chocolate cyst who received laparoscopic surgery in a hospital from March 2017 to April 2019 were randomly selected and divided into the observation group and the control group with 75 cases in each group.In the observation group,the diameter of chocolate cyst was≥3,<5cm;In the control group,the diameter of cyst was 5~10cm.The observation indexes were:(1)Operation time,bleeding volume,rAFS score;(2)Changes of ovarian function(FSH,LH,E2,AMH)at 1,6 and 12 months after operation;(3)Pregnancy rate and recurrence rate within 1 year after operation.Results:(1)The time of operation,the amount of bleeding and the score of RAFS in the observation group were lower than those in the control group(P<0.05);(2)The ovarian function of the observation group decreased slightly at 1,6 and 12 months after operation compared with that before operation(P>0.05);The ovarian function of the control group decreased at 1,6 and 12 months after operation compared with that before operation(P<0.05);The effect of the observation group on the ovarian function was less than that of the control group(P<0.05);(3)The pregnancy rate in the observation group was higher than that in the control group(P<0.05),but the recurrence rate was lower than that in the control group(P<0.05).Conclusion:In patients with chocolate cyst of ovary,especially those with medium size cyst(3~5cm)combined with infertility,laparoscopic surgery is less risky and has greater clinical benefit.