腹腔镜卵巢囊肿剔除术对卵巢囊肿患者卵巢功能、血清抗苗勒管激素、抑制素B的影响及其意义

The Effect of Laparoscopic Ovarian Cyst Removal on Ovarian Function, Serum Anti-Müllerian Hormone and Inhibin B in patients with Ovarian Cysts and its Significance

目的:探讨腹腔镜卵巢囊肿剔除术(LOCR)治疗卵巢囊肿对患者卵巢功能、血清抗苗勒管激素(AMH)、抑制素B(INHB)水平的影响。方法:选取郑州长江中医院2015年1月—2017年6月手术治疗的114例卵巢囊肿患者,以患者手术方法为分组方案,将其分为A组(53例)、B组61例,A组采用LOCR手术治疗,B组采用开腹手术治疗;同时选取60例正常妇女测量相关指标作为对照组;对比三组研究对象的卵巢功能、血清AMH、INHB水平、卵泡刺激素(FSH)、雌激素(E2)、促黄体生成素(LH)。结果:术后3个月,A组患者的卵巢体积与B组比较差异无统计学意义(P>0.05),A组患者的窦卵泡数目多于B组(P<0.05);术前对A、B组患者的血清AMH、INHB基线水平进行检测,两组无实质性差异(P>0.05);术后3个月复查两组患者的AMH水平,A组高于B组(P<0.05),A组的INHB则低于对照组(P<0.05);术前对两组患者的FSH、E2、LH基线水平进行检测比较,差异无有统计学意义(P>0.05);术后3个月FSH、LH再次复查A组患者则均低于B组(P<0.05),E2水平组间对比,A组则高于B组(P<0.05)。结论:LOCR治疗卵巢囊肿较开腹手术更加有利于术后卵巢功能的恢复,避免血清AMH、INHB水平在术后大幅下降。

Objective: To investigate the effect of laparoscopic ovarian cystectomy(LOCR) on ovarian function, serum antiMüllerian hormone(AMH) and inhibin B(INHB) levels in patients with ovarian cysts. Methods: 114 patients with ovarian cysts treated with surgery from January 2015 to June 2017 were enrolled. According to the surgical method, they were divided into group A(53 cases) and group B(61 cases). At the same time, 60 normal women were selected to measure related indicators as the control group. Group A was treated with LOCR and group B was used open surgery. Ovarian function, serum AMH, INHB levels, follicle stimulating hormone(FSH), estrogen(E2), luteinizing hormone(LH) changes in the two groups were compared. Results: At 3 months after operation, there was no statistically significant difference in ovarian volume between group A and group B(P>0.05).The number of antral follicles in group A was higher than that in group B(P<0.05). The baseline levels of serum AMH and INHB in the two groups were tested before operation, and there was no substantial difference between the two groups(P>0.05). Three months after operation, the serum AMH level in group A was higher than that in group B(P<0.05) and INHB of group A was lower than that of the control group(P<0.05). The baseline levels of FSH, E2, and LH of the two groups of patients were tested and compared before surgery, and the difference was not statistically significant(P>0.05). FSH and LH reexamination at 3 months after surgery in group A were lower than those in group B(P<0.05), E2 level was compared between groups, group A was higher than group B(P<0.05). Conclusion: LOCR treatment of ovarian cysts is more conducive to the recovery of postoperative ovarian function than open surgery, to avoid a significant drop in serum AMH and INHB levels after surgery.