腹腔镜下卵巢囊肿剥除术治疗卵巢囊肿患者的效果及对卵巢储备功能的影响

Effects of laparoscopic ovarian cyst removal and its influence on ovarian reserve function

目的:探讨腹腔镜下卵巢囊肿剥除术治疗卵巢囊肿患者的效果及对卵巢储备功能的影响。方法:回顾性分析2018年1月至2020年1月该院收治的74例卵巢囊肿患者的临床资料,根据手术方法不同将其分为对照组和观察组各37例。对照组采用开腹卵巢囊肿剥除术治疗,观察组采用腹腔镜下卵巢囊肿剥除术治疗。比较两组围术期相关指标(术中出血量、手术时间、首次下床时间及排气时间)水平、手术前后血清炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平、性激素[黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)]水平、卵巢储备功能[抗缪勒管激素(AMH)、卵泡数量],以及术后并发症发生率。结果:观察组术中出血量少于对照组,手术时间、首次下床时间及排气时间均短于对照组,术后血清IL-6、TNF-α水平及并发症发生率均低于对照组,差异均有统计学意义(P<0.05);术后,两组LH、FSH水平均升高,AMH、E2水平均降低,卵泡数量均减少,但观察组LH、FSH水平低于对照组,AMH、E2水平高于对照组,卵泡数量多于对照组,差异有统计学意义(P<0.05)。结论:腹腔镜下卵巢囊肿剥除术治疗卵巢囊肿患者,可减少术中出血量,加快术后康复,保护卵巢储备功能,稳定激素水平,降低炎性因子水平,效果优于开腹卵巢囊肿剥除术。

Objective:To investigate effects of laparoscopic ovarian cyst removal and its influence on ovarian reserve function.Methods:The clinical data of 74 patients with ovarian cysts admitted to the hospital from January 2018 to January 2020 were retrospectively analyzed.According to different surgical methods,they were divided into control group and observation group,37 cases in each group.The control group was treated with open ovarian cyst removal,while the observation group was treated with laparoscopic open ovarian cyst removal.The perioperative related index levels(intraoperative blood loss,operation time,first out-of-bed time and exhaust time),the serum inflammatory factor levels[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]before and after the surgery,the sex hormone levels[luteinizing hormone(LH),follicle stimulating hormone(FSH),estradiol(E2)],the ovarian reserve function[anti mullerian hormone(AMH),number of follicles],and the incidence of postoperative complications were compared between the two groups.Results:The intraoperative blood loss in the observation group was less than that in the control group;the operation time,the first out-of-bed time and the exhaust time were shorter than those in the control group;the levels of serum IL-6 and TNF-αand the incidence of complications were lower than those in the control group;and the differences were statistically significant(P<0.05).After the surgery,the levels of LH and FSH in the two groups increased,the levels of AMH and E2,and the number of follicles decreased.However,the levels of LH and FSH in the observation group were lower than those in the control group,the levels of AMH and E2 were higher than those in the control group,and the number of follicles was more than that in the control group,and the differences were statistically significant(P<0.05).Conclusions:Laparoscopic ovarian cyst removal for the patients with ovarian cysts can reduce the blood loss,accelerate the postoperative rehabilitation,protect the ovarian reserve function,stabilize the hormone levels,and reduce the inflammatory factor levels.Moreover,its prognosis is better than open ovarian cyst removal.