腹腔镜下卵巢囊肿剥除术后创面不同止血方式对残留卵巢的影响

Effect of different hemostatic methods on residual ovaries after laparoscopic ovarian cyst ablation

目的探讨腹腔镜下卵巢囊肿剥除术后创面不同止血方式对残留卵巢的影响。方法纳入研究的实验对象为100例接受子宫内膜异位症腹腔镜卵巢囊肿切除术治疗的患者,患者年龄21~40岁,根据术后止血形式分为电凝止血组(n=50)和缝合止血组(n=50),参与研究患者都签署了知情同意书,两组患者一般资料统计比较无统计学差异。对两组患者行腹腔镜卵巢囊肿切除术,并通过电凝止血和缝合止血两种方式进行比较研究。统计两组患者的促卵泡激素(follicle-stimulating hormone,FSH)、雌二醇(estradiol,E2)和黄体生成素(luteinizing hormone,LH)水平。记录手术期间相关临床参数。术前和术后3个月比较两组患者卵巢卵泡个数及卵巢间质收缩期峰值血流速度(peak systolic velocity,PSV)。结果术前FSH、E2、LH水平比较差异均无统计学意义(均P>0.05),术后3个月缝合止血组较电凝止血组FSH水平降低(P<0.05),E2水平升高(P<0.05),LH水平两组比较差异无统计学意义(P>0.05)。术前两组患者的卵泡个数及PSV比较差异均无统计学意义(均P>0.05),术后3个月缝合止血组较电凝止血组的卵泡个数和PSV升高(均P<0.05)。两组患者手术时间、住院天数、术后感染率比较差异均无统计学意义(均P>0.05),缝合止血组较电凝止血组的术中失血量及抗苗勒管激素(Anti-Müllerian hormone,AMH)降低率降低(均P<0.05)。结论在腹腔镜下卵巢囊肿剥除术后,采用缝合止血可降低手术对卵巢功能的影响。

Objective To investigate the effect of different hemostatic methods on residual ovaries after laparoscopic ovarian cyst ablation.Methods A total of 100 patients who underwent laparoscopic ovarian cyst ablation for endometriosis were included in the study,with the age of 21 to 40 years old.According to the different hemostatic methods,the patients were divided into electrocoagulation hemostasis group(n=50)and suture hemostasis group(n=50).The patients who participated in the study all signed informed consent,and there was no statistically significant difference in the general data between the two groups of patients.Laparoscopic ovarian cyst ablation was performed on the two groups of patients,and a comparative study was conducted on electrocoagulation and suture hemostasis.The levels of follicle-stimulating hormone(FSH),estradiol(E2),and luteinizing hormone(LH)were counted in the two groups of patients.The relevant clinical parameters during surgery were recorded.The number of ovarian follicles and the ovarian interstitial peak systolic velocity (PSV) in the two groups were compared before and 3 months aftersurgery. Results There were no statistically significant differences in the hormone levels beforesurgery (all P>0.05). Three months after surgery, the FSH level of the suture hemostasis group waslower than that of the electrocoagulation hemostasis group (P<0.05), the E2 level of the suturehemostasis group was higher than that of the electrocoagulation hemostasis group (P<0.05), andthere was no statistically significant difference in the LH level between the two groups (P>0.05).There was no statistically significant difference in the number of follicles or PSV between the twogroups before surgery (both P>0.05). Three months after surgery, the number of follicles and PSV inthe suture hemostasis group were higher than those in the electrocoagulation hemostasis group(both P<0.05). There was no statistically significant difference in the operation time, hospitalizationdays, or postoperative infection rate between the two groups (all P>0.05). The suture hemostasisgroup had lower blood loss and lower anti-Müllerian hormone (AMH) reduction rate than theelectrocoagulation hemostasis group (both P<0.05). Conclusion Suture hemostasis can reduce theeffect of laparoscopic ovarian cyst ablation on ovarian function.