腹腔镜下不同微创剥离术对卵巢子宫内膜异位症患者卵巢体积及子宫动脉血流动力学的影响

Effects of different laparoscopic minimally invasive dissection on ovarian volume and uterine artery hemodynamics in patients with ovarian endometriosis

目的观察腹腔镜下不同微创剥离术对卵巢子宫内膜异位症(EMT)患者卵巢体积及子宫动脉血流动力学的影响。方法回顾性分析2017年2月至2020年4月驻马店市第一人民医院收治86例卵巢EMT患者的临床资料,将采用钝性腹腔镜微创剥离术治疗的43例患者纳入对照组,将采用锐性腹腔镜微创剥离术治疗的43例患者纳入观察组。比较观察组与对照组术前与术后3个月卵巢体积、激素水平,同时比较两组术前与术后3个月子宫动脉血流动力学水平。结果术后3个月,两组卵巢体积较术前小,但观察组较对照组大(P<0.05);术后3个月,两组最大血流速度(Vmax)较术前低,搏动指数(PI)、阻力指数(RI)较术前高,但观察组Vmax、PI、RI变化幅度较对照组小(P<0.05);术后3个月,两组血清促卵泡激素(FSH)、黄体生成素(LH)、雌二醇(E2)水平与术前比较,P>0.05,且组间LH、FSH、E2水平比较,P>0.05。结论卵巢EMT患者采用锐性腹腔镜微创剥离术治疗有助于缩小卵巢体积,且对子宫动脉血流动力学及激素水平影响较小。

Objective To observe the effects of different laparoscopic minimally invasive dissection on ovarian volume and uterine artery hemodynamics in patients with ovarian endometriosis(EMT).Methods The clinical data of 86 patients with ovarian EMT treated in the First People’s Hospital of Zhumadian from February 2017 to April 2020 were retrospectively analyzed.Forty-three patients treated with blunt laparoscopic minimally invasive dissection were included in the control group,43 patients treated with sharp laparoscopic minimally invasive dissection were included in the observation group.The ovarian volume and hormone levels were compared between the observation group and the control group before and 3 months after operation,and the uterine artery hemodynamics were compared between the two groups before and 3 months after operation.Results Three months after operation,the ovarian volume of the two groups was smaller than that before operation,but that of the observation group was larger than that of the control group(P<0.05);3 months after operation,the maximum blood flow velocity(Vmax)of the two groups were lower than those before operation,and the pulsatility index(PI)and resistance index(RI)were higher than those before operation.However,the change range of Vmax,PI and RI in the observation group was smaller than that in the control group(P<0.05);3 months after operation,the levels of serum follicle stimulating hormone(FSH),luteinizing hormone(LH)and estradiol(E2)in the two groups were compared with those before operation(P>0.05),and the levels of LH,FSH and E2 were compared between the two groups(P>0.05).Conclusions In patients with ovarian EMT,sharp laparoscopic minimally invasive dissection is helpful to reduce the ovarian volume,and has little effect on uterine artery hemodynamics and hormone levels.