腹腔镜下卵巢子宫内膜异位囊肿剥除术不同止血方法对卵巢功能的影响  

Influence of Different Hemostatic Methods on Ovarian Function in Ovarian Endometriotic Cyst Undergoing Laparoscopic Cystectomy

作　　者：王博[1] 厉碧荣[1] 刘秋红[1] 邹放军[1] 李劼[1] 

机构地区：[1]湖南省人民医院妇科,湖南长沙410002

出　　处：《医学临床研究》2014年第7期1313-1315,共3页Journal of Clinical Research

摘　　要：【目的】探讨腹腔镜下卵巢囊肿剥离中不同止血方式对卵巢功能影响。【方法】卵巢子宫内膜囊肿患者66例，均行腹腔镜下囊肿剥除术，并将其分成两组：镜下缝合组36例、电凝组30例，观察两组术前、术后6个月性激素雌二醇（E2）、卵泡刺激素（FS H ）、黄体生成激素（L H ）水平及窦状卵泡数、卵巢功能正常例数及卵巢储备功能下降例数。【结果】术前两组卵巢功能正常率和卵巢储备功能下降率比较差异无统计学意义（ P ＞0．05）；术后缝合组卵巢功能正常率83．33％（30/36）显著高于电凝组53．33％（16/30）（ P ＜0．05），而卵巢储备功能下降率16．67％（6/36）显著低于电凝组46．67％（14/30）（ P＜0．05）。缝合组E2、窦状卵泡数分别为（198．4±24．90）pmol/L、（7．13±2．25）个显著高于电凝组（153．40±16．8）pmo/L、（5．8±0．9）个（ P＜0．05），而FSH和FSH/LH分别为（10．56±4．56）U/L、2．35±1．26显著低于电凝组（13．72±2．81）U/L、（2．82±0．88）U/L （ P ＜0．05）。【结论】腹腔镜下卵巢保守性手术中，正确的镜下缝合止血与传统电凝术相比，对卵巢组织损伤更小，可更好地保留其功能。Objective To explore the influence of different hemostatic methods on ovarian function in ovarian endometriotic cyst undergoing laparoscopic cystectomy .[Methods] Totally 66 patients with ovarian en-dometriotic cyst underwent laparoscopic cystectomy .All patients were divided into microscopic suture group （ n =36） and electrocoagulation group（ n=30） .Estradiol（E2 ） ,follicle stimulating hormone（FSH） ,luteinizing hormone（LH） ,the number of sinusoidal follicles ,normal ovarian function and the declined ovarian reserve function in two groups were observed before and 6 months after operation .[Results]There was no significant difference in the normal rate of ovarian function and the declining rate of ovarian reserve function before operation bwteem two groups（ P〉0 .05） .After operation ,the normal rate of ovarian function in suture group was markedly higher than that in electrocoagulation group [83 .33% （30/35） vs 53 .33% （16/30）]（ P〈0 .05） , but the declining rate of ovarian reserve function was markedly lower than that in electrocoagulation group [16 . 67% （6/36） vs .46 .67% （14/30）]（ P〈0 .05） .The E2 and number of sinusoidal follicles in suture group were （198 .4 ± 24 .90）pmol/L and （7 .13 ± 2 .25） ,which were markedly higher than those in electrocoagulation group[（153 .40 ± 16 .8）pmo/L and （5 .8 ± 0 .9）]（ P〈0 .05） .FSH and FSH/LH in suture group were （10 .56 ± 4 .56）U/L and （2 .35 ± 1 .26） ,which were markedly lower than those in electrocoagulation group [（13 .72 ± 2 .81）U/L and （282 ± 0 .88）U/L]（ P 〈0 .05） .[Conclusion] During laparoscopic ovarian conservation operation ,correct microscopic suture hemostasis has smaller ovarian injury and can better reserve ovarian function than routine electrocoagulation .

关 键 词：腹腔镜检查 卵巢囊肿 并发症 子宫内膜异位症 并发症 卵巢囊肿 外科学 子宫内膜异位症 外科学 止血 

分 类 号：R711.71[医药卫生—妇产科学]