腹腔镜卵巢囊肿剔除术中止血方式对卵巢基质血流的影响

Effect of Hemostatic Methods on Ovarian Stromal Blood Flow in Laparoscopic Ovarian Cyst Removal

目的探讨腹腔镜卵巢囊肿剔除术中不同止血方式对卵巢基质血流的影响。方法收集行腹腔镜卵巢囊肿剔除术治疗的患者180例。根据随机数字表法将患者分为电凝组、缝合组和电凝+缝合组,各60例。缝合组采用缝合止血法。电凝组电凝止血法。缝合+电凝组用缝合止血联合电凝止血法。比较三组的手术情况及术前、术后3个月、6个月时的卵巢窦状卵泡数(antral follicle counts,AFC)、基质血流收缩期峰速(peak systolic velocity,PSV)。同时对患者术后月经情况进行电话随访。结果组内比较,术后3个月时,缝合组、缝合+电凝组、电凝组AFC、PSV水平明显低于术前(P<0.05)。术后6个月时,缝合组、缝合+电凝组AFC较术后3个月时回升,与术前相近(P>0.05);PSV较术后3个月回升,但仍明显低于术前(P<0.05);电凝组AFC、PSV略回升,但明显低于术前(P<0.05)。组间比较,术后3个月、6个月时,缝合组、缝合+电凝组AFC、PSV均明显高于电凝组(P<0.05);术后3个月、6个月时,缝合组PSV明显高于缝合+电凝组(P<0.05)。缝合组、缝合+电凝组术后月经异常率均明显低于电凝组(P<0.05)。结论缝合联合电凝止血方式能较好的改善腹腔镜卵巢囊肿剔除术患者术后卵巢基质血流,改善其远期卵巢功能。

Objective To investigate the effect of different hemostatic methods on ovarian stromal blood flow in laparoscopic ovarian cyst removal.Methods A total of 180 patients with ovarian cyst underwent laparoscopic cystectomy were collected.According to the random number table method,the patients were divided into electrocoagulation group,suture group and electrocoagulation+suture group,60 cases in each group.The suture group was treated with suture hemostasis.Electrocoagulation group was used electrocoagulation hemostasis.In the suture+electrocoagulation group,suture hemostasis combined with electrocoagulation was used.The operation conditions of the three groups and the number of ovarian antral follicle counts(AFC)and peak systolic velocity(PSV)of stromal blood flow before operation,3 months and 6 months after operation were compared.At the same time,telephone follow-up of the patients’postoperative menstruation was carried out.Results In comparison between the groups,the levels of AFC and PSV in the suture group,suture+electrocoagulation group,and electrocoagulation group were significantly lower than those before the operation at 3 months after operation(P<0.05).At 6 months postoperatively,the AFC of the suture group and the suture+coagulation group recovered compared with that at 3 months after surgery,which was similar to that before surgery(P>0.05);PSV recovered from 3 months after surgery,but it was still significantly lower than that of before surgery(P<0.05);AFC and PSV in the electrocoagulation group rose slightly,but were significantly lower than before operation(P<0.05).In comparison between groups,at 3 and 6 months after operation,the AFC and PSV of the suture group and the suture+electrocoagulation group were significantly higher than those of the electrocoagulation group(P<0.05);at 3 and 6 months after operation,the PSV of the suture group was significantly higher than that of the suture+electrocoagulation group(P<0.05).The postoperative abnormal menstrual rate in the suture group and the suture+electrocoagulation group were significantly lower than that of the electrocoagulation group(P<0.05).ConclusionSuture combined with electrocoagulation hemostasis can improve ovarian stromal blood flow and long-term ovarian function in patients with laparoscopic ovarian cyst removal.