腹腔镜剥除术中缝合止血方法对卵巢囊肿患者血清抗苗勒氏管激素、性激素、窦卵泡数及卵巢体积的影响

Effect of suture hemostasis method used in laparoscopic oophorocystectomy on serum anti-Mullerian hormone,sex hormones,antral follicle count and ovarian volume in patients with ovarian cysts

目的探讨腹腔镜剥除术中缝合止血方法对卵巢囊肿患者血清抗苗勒氏管激素(AMH)、性激素、窦卵泡数及卵巢体积的影响。方法回顾性分析2019年1月至2022年1月在阜阳市妇女儿童医院行腹腔镜剥除术的90例卵巢囊肿患者的临床资料,根据术中缝合止血方法分为镜下缝合组(n=30),双极电凝组(n=30),单极电凝组(n=30),对比三组手术指标,手术前后AMH、卵泡刺激素(FSH)、促黄体生成素(LH)、雌二醇(E2)水平以及窦卵泡数、术后妊娠情况。结果镜下缝合组和双极电凝组术中出血量、手术时间、术后排气时间、下床活动时间、住院时间少于单极电凝组(P<0.05),术后镜下缝合组血清AMH、E2、窦卵泡数高于双极电凝组和单极电凝组(P<0.05),FSH、LH水平低于双极电凝组和单极电凝组(P<0.05)。镜下缝合组自然妊娠率高于双极电凝组和单极电凝组(P<0.05)。结论腹腔镜下卵巢囊肿剥除术镜下缝合止血可减轻对卵巢囊肿患者卵巢功能的影响,提高术后自然妊娠率。

Objective To investigate the effect of suture hemostasis method used in laparoscopic oophorocystectomy on serum anti-Mullerian hormone(AMH),sex hormones,antral follicle count and ovarian volume in patients with ovarian cysts.Methods The clinical data of 90 patients with ovarian cysts who underwent laparoscopic enucleation in Fuyang Women's and Children's Hospital were analyzed retrospectively.According to the suture hemostasis method used during operation,the patients were divided into laparoscopic suture group(n=30),bipolar coagulation group(n=30)and monopolar coagulation group(n=30).The operation related indicators,serum AMH,follicle stimulating hormone(FSH),luteinizing hormone(LH)and estradiol(E2)levels,antral follicle count and postoperative pregnancy were compared among the three groups.Results The intraoperative blood loss,operation time,postoperative exhaust time,time for out-of-bed activities and hospital stay of the laparoscopic suture group and the bipolar coagulation group were less/shorter than those of the monopolar coagulation group(P<0.05).After operation,serum AMH and E2 levels and antral follicle count in the laparoscopic suture group were higher,and the levels of FSH and LH were lower than the other two groups(P<0.05).The natural pregnancy rate in the laparoscopic suture group was higher than the other two groups(P<0.05).Conclusion Applying laparoscopic suture hemostasis in laparoscopic oophorocystectomy can reduce the adverse influence on ovarian function and increase the natural pregnancy rate.