腹腔镜下囊肿剔除术中应用不同止血方法效果比较

Comparison of the effect of different hemostatic methods during laparoscopic cystectomy

目的:探究腹腔镜下囊肿剔除术中不同止血方法对患者卵巢功能、性激素及性功能的影响。方法:将2018年1月-2019年1月本院收治的240例卵巢囊肿患者随机分为电凝组和缝合组各120例,均行腹腔镜下囊肿剔除术,术中电凝组电凝止血、缝合组缝合止血,比较两组手术情况、术后卵巢功能、性激素及性功能。结果:缝合组手术时间、术后总出血量多于电凝组,术后引流量少于电凝组(P<0.05);术后6个月,电凝组卵巢截面积较术前无差异(P>0.05),窦卵泡数较术前减少,卵泡刺激素(FSH)、促黄体生成素(LH)水平较术前升高,雌二醇(E_(2))水平较术前降低(P<0.05);缝合组者卵巢截面积、窦卵泡数、FSH、E_(2)、LH较术前无差异(P>0.05);组间比较,术后6个月两组卵巢截面积无差异(P>0.05),缝合组窦卵泡数多于电凝组,FSH、LH水平低于电凝组,E_(2)水平高于电凝组(P<0.05);术前及术后6个月,两组女性性功能量表(FSFI)性欲望、性唤起、阴道润滑度、性高潮、性生活活满意度、性交疼痛评分比较均无差异(P>0.05)。结论:腹腔镜下囊肿剔除术治疗时,术中采用缝合止血法对患者卵巢功能、性激素及性功能影响更小。

Objective:To explore the influence of different hemostatic methods during laparoscopic cystectomy of patients on their ovarian function,sex hormones levels,and sexual function.Methods:A total of 240 patients with ovarian cysts who had been laparoscopic cystectomy were randomly divided into group A(120 patients with electrocoagulation hemostasis)and group B(120 patients with suture hemostasis)from January 2018 to January 2019.The surgical conditions,ovarian function,sex hormones levels,and sexual function of the patients were compared between the two groups.Results:The operation time and total postoperative blood loss of the patients in group B were significantly longer than those of the patients in group A,and the postoperative drainage volume of the patients in group B was significantly less than that of the patients in group A(P<0.05).In the 6th month after operation,there was no significant difference in the ovarian crosssectional area of the patients between the two groups(P>0.05).The number of antrum follicles decreased,the levels of follicle stimulating hormone(FSH)and luteinizing hormone(LH)of the patients in the two groups had increased significantly,and the level of estradiol(E_(2))of the patients in the two groups had increased significantly increased(P<0.05).The ovarian cross-sectional area,the number of antral follicles,and the levels of FSH,E_(2),and LH of the patients in group B had no significantly different from those before operation(P>0.05).There was no significant difference in the ovarian cross-sectional area of the patients in the 6th month after operation between the two groups(P>0.05).The number of antral follicles of the patients in group B was significantly more than that of the patients in group A,the levels of FSH and LH of the patients in group B were significantly lower than those of the patients in group A,and the level of E_(2) of the patients in group B was significantly higher than that of the patients in group A(P<0.05).Before and 6 months after operation,there were no significant differences in the scores of sexual desire,sexual arousal,vaginal lubrication,orgasm,satisfaction with sexual life,and pain during sexual intercourse by Female Sexual Function Scale(FSFI)of the patients between the two groups(P>0.05).Conclusion:The suture hemostasis during laparoscopic cystectomy surgery of the patients has less impact on their ovarian function,sex hormones levels,and sexual function.