腹腔镜下卵巢巧克力囊肿剥除术对卵巢功能及助孕结局的影响  

Effect of laparoscopic chocolate cyst removal on ovarian function and pregnancy outcomes

作　　者：程会芳[1] 曲丽霞[1] 权丽丽[1] CHENG Hui-fang;QU Li-xia;QUAN Li-li(Department of Gynaecology,Sanmenxia Central Hospital Sanmenxia Maternal and Child Health Hospital,Sanmenxia,Henan 472000,China)

机构地区：[1]三门峡市中心医院,三门峡市妇幼保健院妇科,河南三门峡472000

出　　处：《医药论坛杂志》2021年第9期93-96,共4页Journal of Medical Forum

摘　　要：目的分析卵巢巧克力囊肿不孕患者采用腹腔镜下囊肿剥除术后对助孕结局及卵巢功能的影响。方法纳入三门峡市中心医院2018年10月—2019年12月收治的卵巢巧克力囊肿患者70例,将采用注水分离法剥离囊肿的35例作为研究组,将同期采用腹腔镜囊肿直接剥离术的35例作为对照组。研究组采用注水分离法剥离囊肿,对照组采用腹腔镜囊肿直接剥离术,比较两组手术相关指标、卵巢功能及助孕情况。结果研究组术中出血量少于对照组,手术时间明显短于对照组,病灶及卵巢皮质剥除厚度小于对照组,组间差异明显(P<0.05)。较之术前,两组术后血清卵泡刺激素(follicle-stimulating hormone,FSH)、黄体生成素(luteinizing hormone,LH)及雌二醇(estradiol,E2)水平均发生显著改变,术后3个月研究组患者E2水平高于对照组,LH、FSH水平均显著低于对照组(P<0.05)。实施手术治疗前,两组患者的血清抗苗勒激素(anti miillerian hormone,AMH)、抑制素B(inhibin B,INHB)及窦状卵泡数目(sinus follicular follicles,Fo)水平,差异无统计学意义(P>0.05)。研究组术后AMH、INHB与对照组比较均明显较低,且研究组术后Fo个数较对照组多,组间差异有统计学意义(P<0.05)。随访1年,研究组复发率低于对照组,受精率、临床妊娠率以及优质胚胎率均高于对照组,对比差异明显(P<0.05)。结论在应用腹腔镜治疗卵巢巧克力囊肿时,为有效增强患者的卵巢储备能力,减轻患者的卵巢功能损伤,应采用注水分离法,对提升患者自然妊娠率及改善预后疗效显著。Objective To analyze the outcome of assisted pregnancy and ovarian function in infertile patients with chocolate cyst of ovary after laparoscopic cyst removal.Methods Totally 70 patients with ovarian chocolate cysts admitted to our hospital from October 2018 to December 2019 were enrolled and divided into groups by random number table method,35 patients in each group.In the study group,the cysts were separated by water injection,and in the control group,the cysts were separated by laparoscopy,and the indicators related to surgery,ovarian function and pregnancy aid were compared between the two groups.Results The amount of intraoperative blood loss in the study group was less than that in the control group,the operation time was significantly shorter than that in the control group,and the thickness of lesion and ovarian cortex stripping was smaller than that in the control group,with significant difference between groups(P<0.05).Compared with the preoperative,the levels of serum follicle-stimulating hormone(FSH),luteinizing hormone(LH)and estradiol(E2)in both groups were significantly changed,and E2 levels in the research group 3 months after operation were higher than those in the control group,while LH and FSH levels were significantly lower than those in the control group(P<0.05).Before the operation,the two groups of patients were close in terms of anti-miillerian hormone(AMH),inhibitor B(INHB)and sinus follicles(Fo),and the difference was not statistically significant(P>0.05).The postoperative AMH and INHB of the study group were significantly lower than those of the control group,and the number of postoperative Fo of the study group was more than that of the control group,with significant difference between groups(P<0.05).Follow-up for 1 year showed that the recurrence rate of the study group was lower than that of the control group,and the fertilization rate,clinical pregnancy rate and high quality embryo rate were all higher than that of the control group,with significant differences(P<0.05).Conclusion In

关 键 词：助孕结局 卵巢功能 剥除术 腹腔镜 卵巢巧克力囊肿 

分 类 号：R711.75[医药卫生—妇产科学]