经脐单孔腹腔镜手术在卵巢囊肿肥胖患者中的应用效果及对卵巢功能、ROS、AOPP水平的影响

Application effect of transumbilical single-port laparoscopic surgery in obese patients with ovarian cysts and its influences on ovarian function,ROS and AOPP levels

目的探究经脐单孔腹腔镜手术在卵巢囊肿肥胖患者中的应用效果及对卵巢功能、活性氧(ROS)、晚期蛋白氧化产物(AOPP)水平的影响。方法择取2018年3月至2021年5月我院收治的80例卵巢囊肿肥胖患者作为研究对象,根据治疗方案不同将其分为对照组(n=40)与观察组(n=40)。对照组接受常规腹腔镜手术,观察组接受经脐单孔腹腔镜手术。比较两组的围术期恢复指标、疼痛程度、卵巢功能相关指标、ROS及AOPP水平、子宫动脉血流力学指标、卵泡质量。结果观察组的手术时间、导尿时间、首次下床活动时间、排气时间、住院时间均短于对照组,术后24 h视觉模拟评分法(VAS)评分低于对照组,差异具有统计学意义(P<0.05)。出院时,两组的抗苗勒管激素(AMH)、雌二醇(E_(2))、卵泡刺激素(FSH)、黄体生成素(LH)水平均低于术前,且观察组低于对照组(P<0.05)。术后24 h,两组的ROS、AOPP水平均显著高于术前,但观察组低于对照组,差异具有统计学意义(P<0.05);出院时,两组的ROS、AOPP水平均高于术前,但观察组低于对照组,差异具有统计学意义(P<0.05)。出院时,两组的舒张末期血流速度(EDV)、收缩期峰值血流速度(PSV)、阻力指数(RI)、搏动指数(PI)均低于术前,且观察组显著低于对照组,差异具有统计学意义(P<0.05)。术后1个月,观察组的优势卵泡数量多于对照组,卵泡直径大于对照组,差异具有统计学意义(P<0.05)。结论采用经脐单孔腹腔镜手术治疗卵巢囊肿肥胖患者不仅能调节ROS、AOPP及子宫动脉血流动力学指标水平,还能缩短住院时间、促进卵巢功能恢复、改善卵泡质量,值得推广。

Objective To explore the application effect of transumbilical single-port laparoscopic surgery in obese patients with ovarian cysts and its influences on ovarian function,reactive oxygen species(ROS)and advanced oxidation protein products(AOPP)levels.Methods A total of 80 obese patients with ovarian cysts admitted in our hospital from March 2018 to May 2021 were selected as the research objects,and the patients were divided into control group(n=40)and observation group(n=40)according to the different treatment schemes.The control group received conventional laparoscopic surgery,and the observation group received transumbilical single-port laparoscopic surgery.The perioperative recovery indexes,pain degree,ovarian function related indexes,ROS and AOPP levels,uterine artery hemodynamics indexes and follicular quality of the two groups were compared.Results The operation time,catheterization time,first ambulation time,exhaust time and hospitalization time in the observation group were shorter than those in the control group,and the Visual Analogue Scale(VAS)score at 24 h after operation was lower than that in the control group,and the differences were statstically significant(P<0.05).At discharge,the levels of anti-mullerian hormone(AMH),estradiol(E_(2)),follicle-stimulating hormone(FSH)and luteinizing hormone(LH)in the two groups were lower than those before operation,and those in the observation group were lower than the control group(P<0.05).At 24 h after operation,the levels of ROS and AOPP in the two groups were significantly higher than those before operation,but those in the observation group were lower than the control group,and the differences were statistically significant(P<0.05);at discharge,the levels of ROS and AOPP in the two groups were higher than those before operation,but those in the observation group were lower than the control group,and the differences were statistically significant(P<0.05).At discharge,the end diastolic velocity(EDV),peak systolic velocity(PSV),resistance index(RI)and pulsatility index(PI)of the two groups were lower than those before operation,and those of the observation group were significantly lower than the control group,and the differences were statstically significant(P<0.05).One month after operation,the number of dominant follicles in the observation group was more than that in the control group,and the diameter of follicles was larger than that in the control group,and the differences were statstically significant(P<0.05).Conclusion Transumbilical single-port laparoscopic surgery for obese patients with ovarian cysts can not only regulate the levels of ROS,AOPP and uterine artery hemodynamics indexes,but also shorten the hospitalization time,promote the recovery of ovarian function and improve the quality of follicles,which is worthy of promotion.