穿刺抽吸术与水分离法剥除术对卵巢子宫内膜异位囊肿患者卵巢储备及生育功能的影响  

Effects of puncture aspiration and hydro-dissection stripping on ovarian reserve and fertility function in patients with ovarian endometriosis cyst

作　　者：翁继峰 汪小月 夏丽 徐芹 WENG Ji-feng;WANG Xiao-yue;XIA Li;XU Qin(Department of Obstetrics and Gynecology,901th Hospital of Joint Logistics Support Force of PLA,Hefei Anhui 230000,China)

机构地区：[1]解放军联勤保障部队第901医院妇产科,安徽合肥230000

出　　处：《局解手术学杂志》2020年第9期738-742,共5页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的比较穿刺抽吸术与水分离法剥除术对卵巢子宫内膜异位囊肿(OEM)患者卵巢储备功能和生育功能的影响。方法选取2014年12月至2018年6月本院收治的OEM患者80例,根据手术方式将其分为观察组(行阴道超声引导下穿刺抽吸术)和对照组(行腹腔镜下水分离法囊肿剥除术),每组40例。比较2组患者的手术情况、手术前后卵巢储备功能和术后生育功能。结果观察组患者术中出血量和住院时间少/短于对照组,但手术时间长于对照组,差异均有统计学意义(P<0.05);2组患者平均抽液量和手术前后血红蛋白变化量比较,差异无统计学意义(P>0.05)。术后1、3、6个月,2组患者血清FSH、LH、E 2和AMH水平比较,差异有统计学意义(P<0.05);2组患者AFC比较差异有统计学意义(P<0.05),但卵巢体积和卵巢收缩峰值流速比较差异无统计学意义(P>0.05)。术后随访1年,观察组患者的自然流产率低于对照组,差异有统计学意义(P<0.05);但2组患者的再次妊娠率和复发率比较,差异无统计学意义(P>0.05)。结论穿刺抽吸术与水分离法剥除术在治疗OEM方面效果相当,与水分离法剥除术相比,穿刺抽吸术对患者卵巢储备功能的影响较小,可降低患者的自然流产率。Objective To compare the effects of puncture aspiration and hydro-dissection stripping on ovarian reserve function and fertility function in patients with ovarian endometriosis cyst(OEM).Methods A total of 80 OEM patients who were admitted to our hospital from December 2014 to June 2018 were enrolled,and they were divided into the observation group(vaginal ultrasound-guided puncture aspiration)and the control group(laparoscopic hydro-dissection stripping)according to the operation methods,40 cases in each group.The surgical situations,ovarian reserve function before and after surgery,and postoperative fertility function were compared between the two groups.Results The intraoperative blood loss and hospitalization time in the observation group were less/shorter than those in the control group,while the operation time was longer than that in the control group,the differences were statistically significant(P<0.05).There was no statistically significant difference in average fluid draining volume and changes of hemoglobin before and after surgery between the two groups(P>0.05).At 1,3,6 months after surgery,there were statistically significant differences in levels of serum FSH,LH,E 2 and AMH between the two groups(P<0.05),the difference in AFC between the two groups was statistically significant(P<0.05),but no statistically significant difference was found in ovarian volume or ovarian peak systolic velocity between the two groups(P>0.05).The postoperative follow-up for 1 year showed that spontaneous abortion rate in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05),while there was no significant difference in re-pregnancy rate and recurrence rate between the two groups(P>0.05).Conclusion Puncture aspiration and hydro-dissection stripping are equivalent in the treatment of OEM.Compared with hydro-dissection stripping,puncture aspiration has less effect on ovarian reserve function,which can reduce spontaneous abortion rate of patients.

关 键 词：卵巢子宫内膜异位囊肿 穿刺抽吸术 水分离法剥除术 卵巢储备功能 生育功能 

分 类 号：R711.71[医药卫生—妇产科学]