腹腔镜卵巢囊肿剥除术中不同缝合止血法对良性卵巢囊肿患者卵巢储备功能的影响  

Influence of Different Suture Hemostasis Methods on Ovarian Function during Laparoscopic Benign Ovarian Cystectomy

作　　者：徐婉 王丽梅 卢翠敏 魏特曼 王树鹤 XU Wan;WANG Li-mei;LU Cui-min;WEI Te-man;WANG Shu-he(Department of Gynaecology and Obstetrics,the Seventh Medical Center of PLA General Hospital,Beijing 100700,China;Department of Gynaecology and Obstetrics,Beijing Luhe Hospital Affiliated to Capital Medical University,Beijing 101149,China)

机构地区：[1]解放军总医院第七医学中心妇产科,北京100700 [2]首都医科大学附属北京潞河医院妇产科,北京101149

出　　处：《临床误诊误治》2020年第10期90-95,共6页Clinical Misdiagnosis & Mistherapy

基　　金：首都临床特色应用研究与成果推广项目(Z171100001017161)。

摘　　要：目的探讨腹腔镜卵巢囊肿剥除术中不同缝合止血法对良性卵巢囊肿患者卵巢储备功能的影响。方法选取我院因良性卵巢囊肿行腹腔镜卵巢囊肿剥除术患者60例,据术中缝合止血法的不同均分为内缝合组和外缝合组。内缝合组采用卵巢创面内缝合止血,外缝合组采用卵巢创面外缝合止血。比较两组手术相关指标,不同时段血清抗苗勒管激素(AMH)、卵泡刺激素(FSH)、促黄体生成素(LH)、雌二醇、基础窦卵泡数(AFC)变化情况。结果两组手术均顺利完成,内缝合组手术时间长于外缝合组,术中出血量多于外缝合组,差异有统计学意义(P<0.05)。两组血清AMH水平在术后1个月内均较术前下降,FSH、LH水平在术后1个月内均较术前上升,内缝合组AFC在术后1个月内较术前下降,差异均有统计学意义(P<0.05或P<0.01),且上述指标均在术后3个月恢复至术前水平。内缝合组血清AMH在术后3 d、术后1个月月经期间均低于外缝合组,术后1个月月经期间AFC低于外缝合组,差异有统计学意义(P<0.05);术后3个月后两组上述指标比较差异无统计学意义(P>0.05)。结论外缝合止血法较内缝合止血法在术后短期内更有利于卵巢储备功能的保护,但手术3个月后无差异。Objective To explore the effect of different suture hemostasis methods in laparoscopic ovarian cystectomy on ovarian reserve in patients with benign ovarian cysts.Methods Sixty patients who underwent laparoscopic ovarian cystectomy due to benign ovarian cysts in our hospital were selected.According to the different methods of intraoperative suture to stop bleeding,they were divided into internal suture group and external suture group.The internal suture group received internal suture on the ovarian wound to stop bleeding,and the external suture group received external suture on the ovarian wound to stop bleeding.The operation-related indicators of the two groups were compared,and the changes of serum anti-Müllerian hormone(AMH),follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E 2),and basal antral follicle count(AFC)at different time periods were compared.Results The operations of the two groups were successfully completed.The duration of operation of the internal suture group was longer than that of the external suture group,and the intraoperative blood loss was more than that of external suture group(P<0.05).Serum AMH levels in the two groups were decreased within 1 month after surgery compared with preoperative levels,while FSH and LH levels were increased within 1 month after surgery.The number of AFC in internal suture group was significantly decreased within 1 month after the operation compared with that before the operation(P<0.05 or P<0.01),and the above indicators all recovered to preoperative level at 3 months after the operation.Serum AMH in internal suture group was lower than that in external suture group at 3 days after operation and 1 month after the menstrual period.The number of AFC during menstrual period at 1 month after operation was lower than that in external suture group(P<0.05).There were no significant differences in the above indexes in 3 months after operation between two groups(P>0.05).Conclusion The external suture method is more conducive to the protection of ovar

关 键 词：卵巢囊肿 腹腔镜卵巢囊肿剥除术 卵巢储备功能 缝合止血 抗苗勒管激素 卵泡刺激素 

分 类 号：R711.75[医药卫生—妇产科学]