两种止血方法对卵巢子宫内膜异位囊肿术后卵巢储备功能的影响  

The effect of two hemostasis methods on ovarian reserve function after endometrial cyst excision

作　　者：李芳[1] 程明军[1] 叶玉梅 甘晓卫[1] 曹云桂[1] LI Fang, CHENG Mingjun, YE Yumei, GAN Xiaowei, CAO Yungui(Department of Gynecology, Shanghai Jiading Maternal and Child Health Hospital, Shanghai 201821, China)

机构地区：[1]上海市嘉定区妇幼保健院妇科

出　　处：《中国妇产科临床杂志》2018年第3期235-237,共3页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：上海市嘉定区卫生系统科研项目(KYXM 2014-KY-17);上海市医学重点专科建设项目(B类)(ZK2015B08)

摘　　要：目的探讨腹腔镜卵巢子宫内膜异位囊肿剥除术中创面采用二氧化碳激光消融止血、双极电凝止血两种不同的止血方法对卵巢储备功能的影响。方法选择2014年9月至2016年11月在上海市嘉定区妇幼保健院住院治疗的双侧卵巢子宫内膜异位囊肿患者128例，并随机分为两组，囊肿剥除术中采用二氧化碳激光消融术（研究组A组64例）、双极电凝止血（对照组B组64例）；并于手术前、术后第1、3、6个月及12个月月经周期第3天查血FSH、LH及E2、超声测量双侧卵巢基础窦卵泡计数和卵巢体积等卵巢储备功能的指标。结果术后第1个月月经第3天两组LH、FSH水平、双侧卵巢基础窦卵泡计数、卵巢体积两组差异均无显著性（P〉0．05）；术后第3个月、6个月及12个月A组LH、FSH水平均低于B组（P〈0．05），双侧卵巢基础窦卵泡计数、卵巢体积均大于B组（P〈0．05）；术后第1、3、6个月及12个月，A组的E2水平均高于B组（P〈0．05）。结论腹腔镜卵巢子宫内膜异位囊肿剥除术中采用二氧化碳激光消融术对于卵巢储备功能的影响低于双极电凝组。Objective To investigate the effect of COz laser ablation and bipolar electrocoagulation hemostasis respectively on ovarian reserve function after laparoscopic cystectomy for ovarian endometrial cyst. Methods 128 patients hospitalized in Shanghai Jiading Maternal and Child Health Hospital with bilateral ovarian endometrial cyst who underwent laparoscopic cystectomy were randomly divided into two groups：CO2 laser ablation group （A group） and suture groupbipolar electrocoagulation group （B group）, 64 cases in each group. Patients in A group received CO2 laser ablation for hemostasis, and patients in B group received bipolar electrocoagulation. The serum levels of FSH, LH, E2, basal antra follicle count （AFC） and ovary volume were detected respectively before the operations, 1 month, （the second menstrual cycle after operation）, 3, 6 and 12 months after operation, to determine the ovarian reserve. Results There was no significant difference between the two groups in LH, FSH, AFC and ovary volume in the third menstrual day after surgery （P 〉 0.05）. In the third, sixth and 12 months after surgery, the LH and FSH level of group A were lower than that of group B （P 〉 0.05）, and the AFC and ovary volume of group A were greater than that of group B 0~ 〈 0.05）. The E2 levels of group A was higher than group B （P 〈 0.05） in the first, third, sixth and 12 month after surgery. Conclusion The effect of CO~ laser ablation on the function of ovarian reserve was lower than that of bipolar electrocoagulation after ovary cyst surgery.

关 键 词：卵巢子宫内膜异位囊肿 卵巢储备功能 腹腔镜手术 止血 

分 类 号：R713.6[医药卫生—妇产科学]