腹腔镜下垂体后叶素水囊剥除术与囊肿凝固术对卵巢子宫内膜异位囊肿患者的疗效比较

Comparison of Effect of Laparoscopic Pituitary-Posterior Hormone Water Capsule Removal and Cyst Coagulation on Patients with Ovarian Endometriosis Cyst

目的比较腹腔镜下垂体后叶素水囊剥除术与囊肿凝固术对卵巢子宫内膜异位囊肿患者的疗效。方法选取2019年1月至2021年1月柘城县人民医院妇产科收治的80例卵巢子宫内膜异位囊肿患者。根据手术方式将患者分为剥除组和凝固组,各40例。剥除组患者接受垂体后叶素水囊剥除术治疗,凝固组患者接受囊肿凝固术治疗。比较两组手术时间、术中出血量、肛门排气时间及治疗后复发及疼痛情况。比较两组术前和术后1、3、6个月卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_(2))、黄体酮(P)及抗苗勒管激素(AMH)水平。结果剥除组手术时间和肛门排气时间短于凝固组,术中出血量少于凝固组(P<0.05)。术后1、3、6个月,剥除组FSH、LH水平低于凝固组,剥除组E_(2)、P、AMH水平高于凝固组(P<0.05)。剥除组术后复发率、痛经发生率、盆腔痛发生率及性交痛发生率与凝固组比较,差异无统计学意义(P>0.05)。结论水囊剥除术与囊肿凝固术对卵巢子宫内膜异位囊肿患者的治疗效果显著,但水囊剥除术对患者卵巢功能的损伤更小,术后FSH、LH、P、E_(2)及AMH水平恢复更快。

Objective To compare the effect of laparoscopic pituitary-posterior hormone water capsule removal and cyst coagulation on patients with ovarian endometriosis cyst.Methods From January 2019 to January 2021,80 patients with ovarian endometriosis cyst admitted to the Department of Obstetrics and Gynecology of Zhecheng County People’s Hospital were selected.According to the operation methods,the patients were divided into stripping group and coagulation group,with 40 cases in each group.The patients in stripping group were treated with pituitrin water sac stripping,and the patients in coagulation group received cyst coagulation therapy.The operation time,intraoperative blood loss,anal exhaust time,recurrence and pain after treatment were compared between the two groups.The levels of follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E_(2)),progesterone(P)and anti-Mullerian hormone(AMH)were compared between the two groups before operation and 1,3 and 6 months after operation.Results The operation time and anal exhaust time in stripping group were shorter than those in coagulation group,and the amount of blood loss during operation in stripping group was less than that in coagulation group(P<0.05).At 1,3 and 6 months after operation,the levels of FSH and LH in stripping group were lower than those in coagulation group,while the levels of E_(2),P and AMH in stripping group were higher than those in coagulation group(P<0.05).The recurrence rate and the incidences of dysmenorrhea,pelvic pain and sexual intercourse pain in stripping group were not statistically different from those in coagulation group(P>0.05).Conclusion Water sac stripping and cyst coagulation are effective in the treatment of patients with ovarian endometriosis cyst,but water sac stripping has less damage to patients’ovarian function,and the levels of FSH,LH,P,E_(2) and AMH recover faster after operation.