不同腹腔镜手术方式治疗卵巢成熟性畸胎瘤效果及对卵巢储备功能影响

Effect of different laparoscopic surgeries for treating ovarian mature teratoma and its influence on ovarian reserve function

目的:研究不同腹腔镜手术方式对卵巢成熟性畸胎瘤患者的治疗效果,分析其对患者术后卵巢储备功能影响。方法:选取2015年10月-2017年6月本院收治的卵巢成熟性畸胎瘤患者64例,随机数字法将分为两组各32例,分别采用二孔法或三孔法腹腔镜手术治疗,分析两组手术指标,术后疗效、并发症发生率,放射免疫法测定促卵泡刺激素(FSH)、雌二醇(E2)和促黄体生成素(LH)水平,酶联免疫吸附法测定抗苗勒管激素(AMH)、抑制素B(INHB)水平,超声检测术侧卵巢体积及窦卵泡数量(AFC)。结果:二孔组术中出血量、下床时间、住院时间均小于三孔组(P<0.05)。术后1年,二孔组总有效率(93.8%)高于三孔组(71.9%),并发症发生率(6.3%)低于三孔组(25.0%);两组FSH、E2、LH水平均低于术前且二孔组低于三孔组,AMH、INHB水平高于三孔组;卵巢体积及AFC水平两组均低于术前,且二孔组卵巢体积高于三孔组(均P<0.05)。结论:二孔法腹腔镜手术对卵巢成熟性畸胎瘤治疗效果更佳,可降低患者术后并发症发生,对卵巢储备功能影响更小。

Objective:To study the effect of different laparoscopic surgeries for treating women with ovarian mature teratoma,and to analyze its influence on their ovarian reserve function.Methods:64 women with ovarian mature teratoma were selected and were divided into study group and control group by random number method(32 cases in each group)from October 2015 to June 2017.The women in the study group were treated with two-hole laparoscopic surgery,while the women in the control group were treated with three-hole laparoscopic surgery.The operative indexes,the postoperative curative effect,and the incidence of complications of women in the two groups were analyzed.The levels of basic follicle stimulating hormone(FSH),estradiol(E2),and luteinizing hormone(LH)were measured by radioimmunoassay,the levels of antimullerian hormone(AMH)and inhibin B(INHB)were determined by ELISA,and the surgical ovarian volume and antral follicle count(AFC)were measured by ultrasonography.Results:The amount of intraoperative blood loss,time to bed and hospital stay of women in the study group were significant lower than those of women in the control group(P<0.05).One year after the operation,the total effective rate of women in the study group was 93.8%,which was significant higher than that(71.9%)of women in the control group,but the complication rate of women in the study group was 6.3%,which was significant lower than that(25.0%)of women in the control group.After operation,the levels of FSH,E2,LH,and AFC,and ovarian volume of women in the two groups had decreased significantly,and the levels of FSH,E2,LH of women in the study group were significant lower than those of women in the control group,but ovarian volume of women in the study group was significant higher.After operation,the levels of AMH and INHB of women in the study group were significant higher than those of women in the control group(P<0.05).Conclusion:Two-hole laparoscopic surgery for treating women with ovarian mature teratoma has a better therapeutic effect,which can reduce the incidence of postoperative complications and improve the recovery of ovarian reserve function.