腹腔镜下卵巢巧克力囊肿剥除术中不同分离方案与开腹手术对卵巢巧克力囊肿患者激素水平的影响

Influences of Laparoscopic Excision of Ovarian Chocolate Cyst with Different Separation Schemes and Open Surgery on the Hormone Levels of Patients with Ovarian Chocolate Cysts

目的比较腹腔镜下卵巢巧克力囊肿剥除术中不同分离方案与开腹手术治疗卵巢巧克力囊肿对患者激素水平的影响。方法选取82例卵巢巧克力囊肿患者作为研究对象,选取时间为2018年2月至2020年2月,按照随机抽样法分对照组(开腹手术,30例)与观察组(腹腔镜下卵巢巧克力囊肿剥除术治疗,52例),其中观察组根据分离法分为钝性分离组与注水分离组,各26例。对比术前术后卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_(2)),观察妊娠率、复发率以及并发症(出血、气栓、感染)情况。结果治疗前,3组FSH、LH、E_(2)差异无统计学意义(P>0.05);治疗3个月后,注水分离组FSH、LH低于钝性分离组与对照组,而E_(2)高于钝性分离组与对照组(P<0.05)。注水分离组妊娠率高于钝性分离组与对照组,复发率低于钝性分离组与对照组,并发症发生率低于对照组(P<0.05)。结论腹腔镜下卵巢巧克力囊肿剥除术对卵巢储备功能影响较小,尤其是注水分离法,对卵巢功能影响小。

Objective To compare the influences of laparoscopic excision of ovarian chocolate cyst with different separation schemes and open surgery on the hormone levels of patients with ovarian chocolate cysts.Methods A total of 82 patients with ovarian chocolate cysts were selected as the research objects,and the study period was from February 2018 to February 2020.According to the random sampling method,they were divided into the control group(open surgery,30 cases)and the observation group(laparoscopic excision of ovarian chocolate cyst,52 cases).The observation group was divided into blunt separation group and water injection separation group according to the separation method,with 26 cases in each.The levels of follicle stimulating hormone(FSH),luteinizing hormone(LH)and estradiol(E_(2))before and after operation were compared.The pregnancy rate,recurrence rate and complications(bleeding,air embolism and infection)were observed.Results Before treatment,there was no difference in FSH,LH,and E_(2) among the three groups(P>0.05).After 3 months of treatment,the FSH and LH levels of water injection separation group were lower than those of blunt separation group and the control group.E_(2) level was higher than blunt separation group and control group(P<0.05).The pregnancy rate of water injection separation group was higher than that of blunt separation group and control group,recurrence rate was lower than blunt separation group and control group,and complication rate was lower than control group(P<0.05).Conclusion Laparoscopic ovarian chocolate cyst removal has little effect on ovarian reserve function,especially water injection separation.