卵巢子宫内膜异位囊肿患者腹腔镜下剥离术中不同分离法对AMH、FSH及E2水平的影响

Effects of different methods of separation methods on AMH,FSH,and E2 levels during laparoscopic dissection in patients with ovarian endometriosis cysts

目的分析卵巢子宫内膜异位囊肿患者腹腔镜下剥离术中不同分离法对抗苗勒管激素(AMH)、基础卵泡刺激素(FSH)及雌二醇(Estradiol,E2)水平的影响。方法选取2021年1月至2022年1月期间郑州大学第一附属医院收治的90例卵巢子宫内膜异位囊肿患者,根据治疗方案不同分为对照组44例与观察组46例。对比两组围手术期指标、卵巢功能、术后分离卵巢囊肿囊壁附着的正常卵巢组织阳性率与正常卵泡数以及复发率、妊娠率、并发症发生率。结果观察组术中出血量比对照组少,手术时间、排气时间、下床活动时间比对照组短,卵巢皮质剥离厚度与病灶剥离厚度比对照组薄,差异有统计学意义(P<0.05);两组术前AMH、FSH、E2水平比较,差异无统计学意义(P>0.05);术后3个月、6个月,AMH、E2水平均降低,FSH水平升高,且观察组AMH、E2水平比对照组高,FSH水平比对照组低,差异有统计学意义(P<0.05);观察组术后分离卵巢囊肿囊壁附着的正常卵巢组织阳性率低于对照组,正常卵泡数多于对照组,差异有统计学意义(P<0.05);观察组复发率低于对照组,妊娠率高于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论应用腹腔镜下注水分离法可有效改善卵巢子宫内膜异位囊肿患者围手术期指标,减少损伤卵巢功能,具有一定的安全性。

Objective To analyze the effect of different isolation methods on anti⁃Mullerian hor⁃mone(AMH),basal follicle stimulating hormone(FSH)and estradiol(E2)levels during laparoscopic strip⁃ping in patients with ovarian endometriosis cysts.Methods A total of 90 patients with ovarian endometriosis cysts admitted to the First Affiliated Hospital of Zhengzhou University from January 2021 to January 2022 were selected.The patients were divided into two groups based on different treatment plans:44 cases in the control group and 46 cases in the observation group.Perioperative indices,ovarian function,positive rate of normal ovarian tissue attached to the cystic wall of detached ovarian cysts,number of normal follicles,as well as recur⁃rence rate,pregnancy rate,and complication rate were compared between the two groups.Results In the ob⁃servation group,intraoperative bleeding was less than in the control group.Additionally,operation time,ex⁃haust time and time to get out of bed were all shorter in the observation group compared to the control group.The thickness of ovarian cortex peeling and lesion peeling was also thinner in the observation group(P<0.05).When comparing preoperative AMH,FSH and E2 levels between the two groups,there was no statistically sig⁃nificant difference(P>0.05).At 3 and 6 months post⁃surgery,AMH and E2 levels decreased while FSH levels increased.In the observation group,AMH and E2 levels were higher and FSH levels were lower compared to the control group,with statistically significant differences(P<0.05).The positive rate of normal ovarian tissue attached to the cystic wall of isolated ovarian cysts after surgery was lower in the observation group than in the control group.The number of normal follicles was higher in the observation group,with a statistically signifi⁃cant difference(P<0.05).The recurrence rate in the observation group was lower than in the control group,while the pregnancy rate was higher,with statistically significant differences(P<0.05).There was no statistical⁃ly significant difference when comparing the complication rates of the two groups(P>0.05).Conclusion The application of laparoscopic water injection separation can effectively improve the perioperative outcomes of pa⁃tients with ovarian endometriosis cysts,reduce damage to ovarian function,and ensure a certain level of safety.