腹腔镜卵巢囊肿剥除术中序贯式止血法对卵巢功能的影响研究

目的:探讨腹腔镜卵巢囊肿剥除术中序贯式止血法对卵巢功能的影响。方法:选取良性卵巢囊肿患者120例,随机分成对照组及观察组,每组60例,对照组术中采用传统的双极电凝止血法,观察组术中采用序贯式止血法。观察两组患者术前及术后3个月雌二醇(E2)、黄体生成素(LH)以及促卵泡激素(FSH)水平变化,采用kupperman改良评分法比较两组患者月经和妊娠情况,并且统计两组患者术前及术后3个月卵巢功能正常以及卵巢储备功能下降的发生率。结果:术后3个月对照组E2、LH及FSH水平较术前变化较大,差异均有统计学意义(P0.05),而观察组E2、LH及FSH水平较术前变化较小,仅FSH差异有统计学意义(P0.05),术后3个月两组E2、LH及FSH水平差异均有统计学意义(P0.05);观察组月经改变、围绝经期综合症的发生率与治疗后距妊娠时间均显著少于对照组,差异有统计学意义(P0.05);而妊娠率明显高于对照组患者,差异有统计学意义(P0.05);术后3个月观察组患者卵巢功能正常率显著高于对照组,并且卵巢储备功能下降率显著低于对照组,差异均有统计学意义(P0.05)。结论:腹腔镜卵巢囊肿剥除术中采用序贯式止血法对患者的卵巢功能影响较小,有利于患者术后正常生理功能的恢复,值得在临床上推广应用。

Influence of Sequential Hemostasis on Ovarian Function in Laparoscope Ovarian Cyst Cystectomy

Objective:To investigate the influence of in sequential hemostasis on ovarian function of patients undergoing laparoscope ovarian cyst cystectomy.Methods:A total of 120 patients with benign ovarian cyst were selected and randomly divided into control group(n=60) and observation group(n=60). The control group was treated with intraoperative bipolar electrocoagulation hemostasis; the observation group,sequential hemostasis. Then levels of E2, LH and FSH of two groups were observed before and 3 months after operation. The menstruation and pregnancy status were compared by the Kupperman modified scoring method between the two groups, and the incidence of normal ovarian function and ovarian reserve decline were counted.Results:The levels of E2, LH and FSH of control group greatly changed 3 months after operation compared with before operation, the differences were statistically significant(P<0.05), but those of observation group changed very little compared with before operation, only FSH had a statistical significance (P<0.05). There were significant statistical differences in the levels of E2, LH and FSH between the two groups 3 months after operation (P<0.05). The incidence of menstruation change, perimenopausal syndrome and the time of postoperative pregnancy of observation group were significantly less than those of control group (P<0.05). The pregnancy rate of patients in observation group was significantly higher than that in control group (P<0.05). Three months after the operation, the incidence of normal ovarian function of patients in observation group was significantly higher than that in control group, but the incidence of ovarian reserve decline, lower than that in control group, the differences were statistically significant(P<0.05).Conclusion:Intraoperative sequential hemostasis has less influence on ovarian function of patients in the laparoscope ovarian cyst cystectomy, which is helpful for the postoperative patients to recover their normal physiological functions and is worthy of clinical application.