两种止血法对卵巢子宫内膜异位囊肿剥除术后卵巢储备功能的影响  

The study of ovarian reserve function affected by different haemostasis methods during ovarian endometriosis cysts excision

作　　者：冯兰青[1] 黄惠英[1] 王明波[1] 黄小平[2] 李超强[3] 

机构地区：[1]东莞东华医院妇科,广东东莞523110 [2]东莞东华医院超声科,广东东莞523110 [3]东莞东华医院中心实验室,广东东莞523110

出　　处：《分子诊断与治疗杂志》2013年第5期324-327,共4页Journal of Molecular Diagnostics and Therapy

基　　金：东莞市医疗卫生单位科技计划(20131051010251)

摘　　要：目的探讨腹腔镜下卵巢子宫内膜异位囊肿剥除术中创面采用双极电凝及缝合两种止血方式对卵巢储备功能的影响。方法选择卵巢子宫内膜异位囊肿行腹腔镜手术治疗的患者60例,根据术中创面止血方式随机分为两组：镜下缝合组、双极电凝组,每组各30例。于术前、术后1、6个月月经周期的第2~3天,分别检测患者血清抗苗勒管激素（AMH）、卵泡刺激素（FSH）、黄体生成素（LH）、雌二醇（E2）及阴道超声探测窦状卵泡数目（AFC）、患侧卵巢动脉收缩期峰值血流速度（PSV）为判断卵巢储备功能状态的指标。结果缝合组各项指标手术前后无显著差异（P〉0.05）。电凝组术后E2、AMH水平及AFC、PSV与术前相比显著降低,术后FSH水平较术前显著升高（P〈0.05）。两组患者LH水平手术前后无显著差异（P〉0.05）。电凝组术后1个月及6个月E2、AMH水平及AFC、PSV较缝合组降低更明显,FSH水平与缝合组相比显著升高（P〈0.05）。两组术后共发生卵巢储备功能下降6例（缝合组2例,电凝组4例）。结论腹腔镜下卵巢子宫内膜异位囊肿剥除术中不同的止血方式对卵巢储备功能的影响有差异,其中双极电凝止血法较镜下缝合止血法所致卵巢储备功能下降更加显著。Objective To investigate the effects of two different hemostatic methods（bipolar electrocoagulation and suture） on ovarian reserve function in patients with endometriosis.Methods Sixty patients who underwent laparoscopic surgical treatment for ovarian endometriosis cysts were divided into bipolar electrocoagulation group and sutured group（n=30 in each group）.The average contents of anti-mullerian hormone（AMH）,follicle-stimulating hormone（FSH）,luteinizing hormone（LH）,estradiol（E2）,antral follicle count（AFC）,and peak systolic velocity（PSV） were compared in electrocoagulation group and suture group.Results For the sutured group,the levels of E2,AMH,FSH,AFC and PSV had no signifcant discrepancy（P0.05）.For the electrocoagulation group,the levels of E2,AMH,AFC and PSV decreased signifcantly after operation,while the levels of FSH increased signifcant（P0.05）.For the level of LH,there was no signifcantly discrepancy between two groups（P0.05）.The decreases of E2,AMH,AFC and PSV in the bipolar electrocoagulation group at 1 and 6 months postoperatively were more signifcant than those in the sutured group（P0.05）.And the level of FSH increased signifcantly in the bipolar electrocoagulation group compared to the sutured group（P0.05）.Six patients experienced a decline in ovarian reserve function in both two groups（suture group： n=2;electrocoagulation group： n=4）.Conclusion Different methods of hemostasis during laparoscopic ovarian cyst excision would cause different impacts on ovarian reserve function.The use of bipolar electrocoagulation could decline ovarian reserve function more obvious than the sutured group.

关 键 词：腹腔镜 卵巢子宫内膜异位囊肿 止血方式 卵巢储备功能 抗苗勒管激素 

分 类 号：R713[医药卫生—妇产科学]