腹腔镜卵巢囊肿剔除术治疗卵巢囊肿临床疗效分析

Clinical effect of laparoscopic ovarian cyst excision in the treatment of ovarian cyst

目的研究腹腔镜卵巢囊肿剔除术对卵巢囊肿患者卵巢功能、免疫功能及复发率的影响。方法选取2017年1月—2020年1月宜昌市夷陵区妇幼保健院收治的卵巢囊肿患者74例,根据医师病情判断建议及患者自愿选择手术方式的不同分为开腹组(35例)和腹腔镜组(39例),分别采用传统开腹手术、腹腔镜卵巢囊肿剔除术。比较2组患者手术相关指标、手术前后卵巢功能指标和免疫功能指标,并随访记录1年内患者疾病复发率和再妊娠率。结果与开腹组比较,腹腔镜组胃肠道功能恢复时间、术后住院时间均较短,术中出血量较少(P<0.05);手术1个月后,腹腔镜组促卵泡激素(FSH)、黄体生成素(LH)水平低于开腹组,雌二醇(E2)水平高于开腹组(P<0.05);术后1个月,与开腹组比较,腹腔镜组CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)较高(P<0.05);与开腹组比,腹腔镜组复发率低(P<0.05),2组再妊娠率比较差异不具有统计学意义(P>0.05)。结论与传统开腹手术相比,腹腔镜卵巢囊肿剔除术对卵巢囊肿患者卵巢创伤较小,且术中出血量少、术后恢复快,对免疫功能和卵巢功能影响较小,复发率低,临床应用价值更高。

Objective To study the effect of laparoscopic ovarian cyst excision on ovarian function,immune function and recurrence rate in patients with ovarian cyst.Methods 74 patients with ovarian cysts in our hospital from January 2017 to January 2020 were selected and divided into laparotomy group(35 cases)and laparoscopy group(39 cases)according to the doctor's judgment and suggestions and the patients'voluntary choice of operation methods.Traditional laparotomy and laparoscopic ovarian cyst removal were used respectively.The operation related indexes,ovarian function indexes and immune function before and after operation were compared between the two groups The disease recurrence rate and re pregnancy rate within 1 year were recorded.Results Compared with the open group,the recovery time of gastrointestinal function,postoperative hospital stay and intraoperative blood loss in the laparoscopic group were shorter(P<0.05);after 1 month of operation,the levels of follicle stimulating hormone(FSH)and luteinizing hormone(LH)in the laparoscopic group were lower than those in the open group,and the level of estradiol(E2)was higher than that in the open group(P<0.05);after 1 month of operation,compared with the open group,the levels of CD_(3)^(+),CD_(4)^(+),C in the laparoscopic group were lower D8+ was higher(P<0.05);compared with laparotomy group,the recurrence rate of laparoscopic group was lower(P<0.05),The difference of the rate of re pregnancy between the two groups was not statistically significant(P>0.05).Conclusion Compared with traditional open surgery,laparoscopic ovarian cyst removal has less ovarian trauma,less intraoperative blood loss,faster postoperative recovery,less impact on immune function and ovarian function,lower recurrence rate and higher application value.