腹腔镜下卵巢囊肿剥除术治疗卵巢囊肿的效果及对残留卵巢储备功能、自然妊娠结局的影响

Effect of Laparoscopic Ovarian Cyst Removal on Ovarian Cyst and Its Effect on Residual Ovarian Reserve Function and Natural Pregnancy Outcome

目的分析腹腔镜下卵巢囊肿剥除术治疗卵巢囊肿的效果及对残留卵巢储备功能、自然妊娠结局的影响。方法选取2019年4月-2020年11月行卵巢囊肿剥除术治疗的卵巢囊肿97例,根据手术方式的不同分为对照组48例和观察组49例,其中对照组采用开腹式手术,观察组采用腹腔镜手术。比较2组手术相关情况、免疫功能(IgG、IgM、IgA)、卵巢储备功能[抗苗勒管激素(AMH)、促卵泡激素(FSH)、雌二醇(E 2)]、超声检测指标[卵巢体积(OV)、窦状卵泡数(Fo)]以及自然妊娠结局。结果观察组手术时间、术中出血量以及术后首次下床活动时间均短于或少于对照组(P<0.01)。术后6个月,2组IgG、IgM、IgA、AMH、FSH、E 2水平均较术前明显升高,且观察组高于对照组(P<0.05)。术前及术后6个月,2组OV、Fo比较差异均无统计学意义(P>0.05)。随访24个月内,观察组怀孕时间短于对照组,妊娠率高于对照组(P<0.01)。结论腹腔镜下卵巢囊肿剥除术创伤小,且对卵巢囊肿患者免疫功能以及卵巢储备功能影响较小,更利于患者的术后恢复。

Objective To analyze the effect of laparoscopic ovarian cyst excision on ovarian cyst and its effect on residual ovarian reserve function and natural pregnancy outcome.Methods From April 2019 to November 2020,97 patients with ovarian cyst who were treated by ovarian cyst removal were selected and divided into the control group(n=48)and the observation group(n=49)according to different surgical methods.The control group underwent open surgery and the observation group underwent laparoscopic surgery.Operation-related conditions,immune function(IgG,IgM,IgA),ovarian reserve function[anti-mullerian hormone(AMH),follicle-stimulating hormone(FSH),estradiol(E 2)],ultrasonic detection indexes[ovarian volume(OV),number of sinusoidal follicles(Fo)]and natural pregnancy outcome of the two groups were compared.Results The duration of operation,intraoperative blood loss and first postoperative ambulation time of the observation group were shorter or less than those of the control group(P<0.01).At 6 months after surgery,the levels of IgG,IgM,IgA,AMH,FSH and E 2 in the two groups were significantly increased,which were higher in the observation group than in the control group(P<0.05).Before surgery and at 6 months after surgery,there were no significant differences in OV and Fo between the two groups(P>0.05).Within 24-month follow-up,the pregnancy time of observation group was shorter than that of control group,and the pregnancy rate was higher than that of control group(P<0.01).Conclusion Laparoscopic ovarian cyst removal is less traumatic,and has little impact on the immune function and ovarian reserve function of patients with ovarian cyst,which is more conducive to postoperative recovery of patients.