腹腔镜下卵巢囊肿蒂扭转复位手术对生育功能的影响

Effect of Laparoscopic torsion Reduction of ovarian cyst pedicle on Fertility function

目的探讨腹腔镜下卵巢囊肿蒂扭转复位手术对生育功能的影响。方法选取68例行腹腔镜下卵巢囊肿蒂扭转复位手术治疗的患者,比较患者术前、术后1个月抗苗勒管激素(AMH)、卵泡刺激素(FSH)、促黄体生成素(LH)水平变化,比较患者在不同蒂扭转角度、发病时间、卵巢状态下卵巢功能的恢复情况,统计卵巢大小、卵巢血供和卵泡发育正常患者比例。结果患者术后1个月FSH水平较术前升高,AMH、LH水平较术前降低,差异具有统计学意义(P<0.05)。扭转角度33周患者卵巢大小正常率、卵巢供血正常率、卵泡发育正常率与扭转角度<3周患者比较,差异无统计学意义(P>0.05)。发病时间刃5h患者卵巢大小正常率、卵巢供血正常率、卵泡发育正常率与发病时间<75 h患者比较,差异无统计学意义(P>0.05)。患者卵巢外观呈红润或暗红色卵巢大小正常率、卵巢供血正常率、卵泡发育正常率均为100.00%,均分别高于卵巢外观呈紫黑色患者的85.00%、80.00%、80.00%,差异具有统计学意义(P<0.05)。结论在不考虑切除附件的前提下,卵巢囊肿蒂扭转患者行卵巢囊肿蒂扭转复位手术对卵巢功能恢复正常无显著影响,对保存女性的生育功能具有重要意义。

Objective To investigate the effect of laparoscopic ovarian cyst torsion pedicle reduction on fertility.Methods 68 patients with ovarian cyst pedicle torsion reduction under laparoscopy were selected.The changes of anti Mullerian hormone(AMH),follicle stimulating hormone(FSH)and luteinizing hormone(LH)levels before and 1 month after operation were compared.The recovery of ovarian function under different pedicle torsion angle,onset time and ovarian state were compared,and the size of ovary was counted Proportion of patients with normal ovarian blood supply and follicular development.Results One month after surgery,the level of FSH was higher than that before surgery,while the levels of AMH and LH were lower than that before surgery,with statistical significance(P<0.05).There were no significant differences in normal ovarian size,normal ovarian blood supply and normal follicular development between patients with torsion Angle-S3 weeks and patients with torsion Angle<3 weeks(P>0.05).There were no significant differences in normal ovarian size,normal ovarian blood supply and normal follicular development between patients with onset time-S75 h and patients with onset time<75 h(P>0.05).The rates of normal ovarian size,normal ovarian blood supply and normal follicular development in patients with rosy or dark red ovary appearance were 100.00%,which were higher than 85.00%,80.00%and 80.00%of patients with purple black ovary appearance,respectively,with statistical significance(P<0.05).Conclusion In the absence of accessory removal,torsion and reduction of ovarian cyst pedicle in patients with torsion of ovarian cyst pedicle has no significant effect on the restoration of ovarian function,which is of great significance to the preservation of female fertility.