地诺孕素不同给药时间对经腹腔镜术治疗卵巢巧克力囊肿的疗效及复发情况的影响

Effect of Different Administration Time of Dinopressin on the Efficacy and Recurrence of Ovarian Chocolate Cyst Treated by Laparoscopy

目的探讨地诺孕素不同给药时间对经腹腔镜术治疗卵巢巧克力囊肿的疗效及复发情况的影响。方法选取2019年8月至2022年1月于辽宁省健康产业集团阜新矿总医院接受腹腔镜手术治疗的90例卵巢巧克力囊肿患者为研究对象,按照治疗时机不同分为A组和B组,各40例。A组患者在腹腔镜术前给予地诺孕素,B组患者在腹腔镜术后给予地诺孕素,比较两组患者术前及术后6个月时的性激素指标、卵巢储备功能指标(窦卵泡数和卵巢体积)、基质血流指标,统计两组患者术后1年的自然妊娠、复发情况及妊娠间隔时间。结果术前两组患者血清卵泡刺激素(FSH)、黄体生成素(LH)以及雌二醇(E_(2))水平比较差异无统计学意义(P>0.05);术后6个月时,两组患者FSH、LH、E_(2)水平降低,且A组低于B组,差异有统计学意义(P<0.05)。术前两组患者窦卵泡数和卵巢体积比较,差异无统计学意义(P>0.05);术后6个月时,A组患者窦卵泡数和卵巢体积高于B组,差异有统计学意义(P<0.05)。术前两组患者舒张末期最低血流速度(EDV)、收缩期最高血流速度(PSV)以及阻力指数(RI)比较,差异无统计学意义(P>0.05);术后6个月时A组患者EDV和PSV明显高于B组(P<0.05),两组患者RI比较差异无统计学意义(P>0.05)。术后1年,A组患者自然妊娠率高于B组,复发率低于B组,妊娠间隔时间短于B组,差异有统计学意义(P<0.05)。结论卵巢巧克力肿瘤行腹腔镜手术患者术前给予地诺孕素有助于改善其卵巢储备功能、性激素指标及基质血流指标,同时远期随访在提高患者自然妊娠率、缩短妊娠间隔时间方面具有积极意义。

Objective To explore the effect of different administration time of dinorestrel on the treatment of ovarian chocolate cyst by laparoscopy and its influence on recurrence.Methods A total of 90 patients with chocolate cyst of ovary who received laparoscopic surgery in Fuxin Mine General Hospital of Liaoning Health Industry Group from August 2019 to January 2022 were selected as the study objects,and were divided into group A and Group B according to different treatment times,with 40 cases each.Patients in group A were given dinorgestrel before laparoscopy,and patients in group B were given dinorgestrel after laparoscopy.Sex hormone indexes,ovarian reserve function indexes(sinus follicle and ovarian volume)and stromal blood flow indexes of the two groups were compared before and 6 months after surgery,and natural pregnancy,recurrence and pregnancy interval of the two groups were analyzed.Results There was no significant difference in serum levels of follicle-stimulating hormone(FSH),luteinizing hormone(LH)and estradiol(E_(2))between 2 groups before surgery(P>0.05).At 6 months after surgery,the levels of FSH,LH and E_(2) in 2 groups decreased,and group A was lower than group B,the difference was statistically significant(P<0.05).There was no significant difference in the number of sinus follicles and ovarian volume between the two groups before surgery(P>0.05).At 6 months after operation,the number of sinus follicles and ovarian volume in group A were higher than those in group B,and the difference was statistically significant(P<0.05).Before operation,there was no significant difference in the lowest blood velocity(EDV)at the end of diastolic period,the highest blood velocity(PSV)at systolic period and the resistance index(RI)between the two groups(P>0.05).At 6 months after surgery,EDV and PSV in group A were significantly higher than those in group B(P<0.05),and there was no significant difference in RI between the two groups(P>0.05).One year after surgery,the natural pregnancy rate of group A was higher than that of group B,the recurrence rate was lower than that of group B,and the pregnancy interval was shorter than that of group B,with statistical significance(P<0.05).Conclusion Preoperative administration of denogestrin to patients with ovarian chocolate tumor undergoing laparoscopic surgery can improve their ovarian reserve function,serum indicators and matrix blood flow indicators.At the same time,long-term follow-up is also of positive significance in improving the natural pregnancy rate and shortening the pregnancy interval.