腹腔镜下卵巢囊肿剥除术中电凝止血与缝合止血对卵巢储备功能的影响研究

Effect of Electrocoagulation Hemostasis and Suture Hemostasis on Ovarian Reserve Function during Laparoscopic Ovarian Cyst Excision

目的:探究腹腔镜下卵巢囊肿剥除术中电凝止血与缝合止血对卵巢储备功能的影响。方法:回顾性分析2019年2月-2021年2月在景德镇市第一人民医院接受腹腔镜下卵巢囊肿剥除术治疗的60例患者的临床资料,根据其术中止血方式分为观察组和对照组,各30例。对照组采取电凝止血,观察组采取缝合止血。比较两组卵巢功能指标[促卵泡生成素(FSH)、雌二醇(E_(2))、窦卵泡计数(AFC)]、应激指标[促肾上腺皮质激素(ACTH)、去甲肾上腺素(NE)]及血流动力学[舒张期末流速(EDV)、收缩期峰值流速(PSV)]。结果:术后3个月,对照组FSH水平高于术前1 d,E_(2)及AFC水平均低于术前1 d(P<0.05),观察组FSH、E_(2)及AFC水平与术前1 d相比,差异均无统计学意义(P>0.05)。术后2 h,两组ACTH及NE水平均高于术前1 d,对照组ACTH及NE水平均高于观察组(P<0.05)。术后3个月,两组PSV、EDV水平均高于术前1 d,对照组PSV、EDV均低于观察组(P<0.05)。结论:与缝合止血相比,电凝止血对腹腔镜下卵巢囊肿剥除术后卵巢储备功能及宫腔血流动力学的影响较大,术中应用缝合止血较能够抑制应激反应。

Objective:To investigate the effect of electrocoagulation hemostasis and suture hemostasis on ovarian reserve function during laparoscopic ovarian cyst excision.Method:The clinical data of 60 patients who underwent laparoscopic ovarian cyst excision in Jingdezhen First People’s Hospital from February 2019 to February 2021 were retrospectively analyzed.According to their postoperative hemostasis methods,they were divided into observation group and control group,with 30 cases in each group.The control group was treated with electrocoagulation hemostasis,while the observation group was treated with suture hemostasis.The ovarian function indexes[follicle-stimulating hormone(FSH),estradiol(E_(2)),antral follicle count(AFC)],stress index[adrenocorticotropic hormone(ACTH),norepinephrine(NE)]and hemodynamic[end-diastolic velocity(EDV),peak systolic velocity(PSV)]level were compared between the two groups.Result:At 3 months after operation,the level of FSH in the control group was higher than that at 1 d before operation,and the levels of E_(2) and AFC were lower than those at 1 d before operation(P<0.05).There were no significant differences in the levels of FSH,E_(2) and AFC in the observation group compared with those at 1 d before operation(P>0.05).At 2 h after operation,the levels of ACTH and NE in the two groups were higher than those at 1 d before operation,and the levels of ACTH and NE in the control group were higher than those in the observation group(P<0.05).At 3 months after operation,the levels of PSV and EDV in both groups were higher than those in the 1 d before operation,and the levels of PSV and EDV in the control group were lower than those in the observation group(P<0.05).Conclusion:Compared with suture hemostasis,electrocoagulation hemostasis has a greater effect on ovarian reserve function and uterine hemodynamics after laparoscopic ovarian cyst excision,intraoperative suture hemostasis can inhibit the stress response.