三种止血方案用于腹腔镜下卵巢囊肿剥除术的效果对比

Comparison of efficacy of three hemostatic schemes in laparoscopic ovarian cyst removal

目的比较三种止血方案用于腹腔镜下卵巢囊肿剥除术(LOCR)的临床效果。方法回顾性收集2019年2月至2020年11月于山西省妇幼保健院接受LOCR治疗的147例卵巢囊肿患者资料,根据术中止血方式分为缝合组(49例,缝合止血)、电凝组(53例,电凝止血)、超声刀组(45例,超声刀止血)。比较三组围术期指标、性激素水平、卵巢储备功能指标。结果三组手术时间、术中出血量、术后1 h疼痛程度评分比较,P>0.05。三组术前性激素水平、卵巢储备功能指标比较,P>0.05。随访3个月,缝合组促卵泡生成素、黄体生成素水平低于电凝组及超声刀组(F=51.276、32.852,P<0.05),雌二醇、窦状卵泡计数、卵巢基底动脉血流收缩期峰值水平高于电凝组、超声刀组(F=8.165、36.849、7.058,P<0.05)。结论缝合止血、电凝止血、超声刀止血均可用于LOCR中止血,但缝合止血对卵巢功能影响更小。

Objective To compare the clinical effects of three hemostatic schemes in laparoscopic ovarian cyst removal(LOCR).Methods The data of 147 patients with ovarian cysts who received LOCR treatment in Shanxi Provincial Maternity and Child Health Hospital from February 2019 to November 2020 were retrospectively collected.According to the method of intraoperative hemostasis,they were divided into suture group(49 cases,suture hemostasis)and electrocoagulation group(53 cases,electrocoagulation hemostasis),ultrasonic knife group(45 cases,ultrasonic scalpel hemostasis).The perioperative indexes,sex hormone levels,and ovarian reserve indexes of the three groups were compared.Results Comparison of operation time,intraoperative blood loss,and pain degree scores at 1 hour after operation in the three groups,P>0.05.Comparison of the levels of sex hormones and ovarian reserve before surgery in the three groups,P>0.05.After 3 months of follow-up,the levels of follicle stimulating hormone and luteinizing hormone in the suture group were lower than those in the electrocoagulation group and the ultrasonic knife group(F=51.276,32.852,P<0.05),and estradiol The levels of antral follicle count and peak systolic blood flow of the ovarian basilar artery were higher than those in the electrocoagulation group and the ultrasonic knife group(F=8.165,36.849,7.058,P<0.05).Conclusions Suture hemostasis,electrocoagulation hemostasis and ultrasonic knife hemostasis can be used for hemostasis in locr,but suture hemostasis has less effect on ovarian function.