OEMC剥除术中三种不同止血方法对卵巢功能恢复的影响

Comparison of the effects of three different methods of hemostasis on ovarian function recovery in OEMC stripping

目的 :探讨双极电凝止血、超声刀止血及缝合法止血在腹腔镜卵巢子宫内膜异位症囊肿(OEMC)剥除术中的应用对卵巢功能恢复的影响。方法 :对本院妇产科2013年5月~2015年1月采用OEMC剥除术治疗的183例患者进行回顾性分析,根据术中选择的不同止血方法进行分组,其中电凝组70例、超声刀组59例、缝合组54例,分别于术前、术后第1、3、6个月进行卵巢功能相关指标进行测量,对比三组卵巢功能恢复差异。结果 :术前电凝组、超声刀组和缝合组患者的FSH、LH、E2、AMH测定值差异均无统计学意义;术后1个月、3个月、6个月电凝组、超声刀组的FSH、E2测定值显著的高于缝合组患者,术后1个月、3个月、6个月电凝组、超声刀组的LH、AMH测定值显著的低于缝合组患者;术前电凝组、超声刀组和缝合组患者的窦状卵泡个数、PI、RI测定值差异均无统计学意义;术后6个月电凝组、超声刀组的PI、RI测定值显著的高于缝合组患者,术后6个月电凝组、超声刀组的窦状卵泡个数显著的低于缝合组患者。结论 :双极电凝止血、超声刀止血在OEMC剥除术中的应用对卵巢功能影响较大,应尽量多采用缝合法止血。

Objective To investigate the effect of bipolar coagulation hemostasis, ultrasonic knife hemostasis and suture hemostasis on the ovarian function recovery in laparoscopic ovarian endometriosis cyst(OEMC). Methods For obstetrics and gynecology hospital in May 2013 ~ January 2015 using OEMC cystectomy treating 183 patients were retrospectively analyzed,grouped according to different methods of intraoperative hemostasis choice, which electrocoagulation group of 70 cases, ultrasound knife 59 cases of group, suture group, 54 patients were before surgery, 1, 3, 6 months ovarian function relevant indicators to measure, comparing three groups of ovarian function recovery differences. Results Preoperative coagulation group, harmonic scalpel and suture group patients of FSH, LH, E2, AMH measured values were not significantly different; after 1 month, 3 months, 6 months coagulation group, FSH harmonic scalpel group, significantly higher than the measured value E2 suture group patients, after 1 month, 3 months, 6 months, coagulation group, LH harmonic scalpel group, AMH measured values significantly lower than the suture group patients; no significant difference 6 months after coagulation group, PI harmonic scalpel group, RI measured values significantly higher than the suture group patients, 6 months after coagulation group, the number of antral follicles was significantly ultracision lower than the suture group patients. Conclusion Bipolar coagulation, ultrasonic scalpel hemostasis hemostasis OEMC cystectomy in ovarian function applications on larger, suture hemostasis should try to use more.[Key words]