腹腔镜下卵巢子宫内膜异位囊肿剔除术应用不同止血方式对患者术后的影响

Effect of Different Hemostatic Methods on Patients After Laparoscopic Ovarian Endometriosis Cyst Removal

目的:探讨腹腔镜下卵巢子宫内膜异位囊肿剔除术应用不同止血方式对患者术后的影响。方法:选取2019年2月~2020年4月本院腹腔镜下卵巢子宫内膜异位囊肿剔除术患者50例,依随机数字表法分为对照组和观察组各25例。观察组接受镜下缝合止血,对照组接受双极电凝止血,比较两组术后效果。结果:与术前比,术后3~6个月两组经期时间均延长,且观察组均长于对照组;两组月经周期均呈先延长后缩短的趋势,且观察组均长于对照组;与术前比,术后3~6个月,对照组窦状卵泡数目先减少后增加,且均少于观察组,收缩期峰值血流速度水平均先降低后升高,且均低于观察组;对照组血清促卵泡素、黄体生成素水平均升高,且高于观察组,血清雌二醇水平降低,且低于观察组;术后1年,观察组自然妊娠率高于对照组,显示差异均具统计学意义(P<0.05)。结论:镜下缝合止血可延长腹腔镜下卵巢子宫内膜异位囊肿剔除术患者经期,提高卵巢储备功能,改善患者妊娠结局,同时相较于电凝止血,镜下缝合止血更易于维持患者性激素水平稳定。

Objective:To investigate the effect of different hemostatic methods on patients after laparoscopic ovarian endometriosis cyst removal.Methods:From February 2019 to April 2020,50 patients with laparoscopic ovarian endometriosis cyst removal were randomly divided into control group and observation group.The observation group received suture hemostasis under microscope and the control group received bipolar electrocoagulation hemostasis.The postoperative effects of the two groups were compared.Results:Compared with that before operation,the menstrual period of the two groups was prolonged 3~6 months after operation,and the observation group was longer than that of the control group;The menstrual cycle of the two groups was first prolonged and then shortened,and the observation group was longer than that of the control group;Compared with before operation,3~6 months after operation,the number of AFC in the control group decreased first and then increased,which were less than those in the observation group,and the level of PSV decreased first and then increased,which were lower than those in the observation group;The levels of serum FSH and LH in the control group were higher than those in the observation group,and the level of serum E_(2) was lower than those in the observation group;One year after operation,the natural pregnancy rate in the observation group was higher than that in the control group(P<0.05).Conclusion:Microscopic suture hemostasis can prolong the menstrual period,improve ovarian reserve function and improve pregnancy outcome.At the same time,compared with electrocoagulation hemostasis,microscopic suture hemostasis is easier to maintain the stability of sex hormone level in patients.