不同止血方式对腹腔镜下卵巢子宫内膜异位囊肿剥除术后卵巢储备功能的影响  

Effects of different hemostatic methods on ovarian reservation after laparoscopic ovary endometrioma cystectomy

作　　者：王玉[1] 盛洁[1] 靳灵鸽[1] 蒋子文 卢丹[1] Wang Yu;Sheng Jie;Jin Lingge;Jiang Ziwen;Lu Dan(Department of Gynecology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院妇科,100026

出　　处：《中华妇幼临床医学杂志（电子版）》2021年第4期420-424,共5页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：国家自然科学基金项目(81801406)。

摘　　要：目的探讨双极电凝止血和缝合止血,对腹腔镜下卵巢囊肿剥除术(LOC)后,卵巢子宫内膜异位囊肿(OEC)患者卵巢储备功能(OR)的影响。方法选择2014年12月至2017年8月,于北京妇产医院接受LOC的159例中、重度OEC患者为研究对象。按照术中采取的止血方式,将其分为电凝组(n=74,采用双极电凝止血)和缝合组(n=85,采用缝合止血)。对2组患者术前双侧卵巢囊肿直径及血清抗苗勒管激素(AMH)水平,以及术后1年双侧卵巢直径及血清AMH水平,采用Mann-Whitney U检验进行统计学比较。本研究经北京妇产医院伦理委员会批准(审批文号:2016-KY-044-01)。所有受试者知情同意并签署知情同意书。结果①2组OEC患者年龄、人体质量指数、修正的美国生育学会(r-AFS)评分等比较,差异均无统计学意义(P>0.05)。②2组OEC患者LOC术前及术后1年血清AMH水平比较,以及术前双侧卵巢囊肿直径及术后1年双侧卵巢直径比较,差异均无统计学意义(P>0.05)。结论双极电凝止血和缝合止血,对OEC患者LOC术后1年的OR影响无明显差别。Objective To investigate effects of bipolar coagulation and suture hemostasis on ovarian reservation(OR)of patients with ovarian endometrial cysts(OEC)after laparoscopic ovarian cystectomy(LOC).Methods A total of 159 patients with moderate and severe OEC who underwent LOC in Beijing Obstetrics and Gynecology Hospital from December 2014 to August 2017 were selected as research subjects.According to hemostatic methods in LOC,they were divided into electrocoagulation group(n=74,stopped bleeding by bipolar electrocoagulation)and suture group(n=85,stopped bleeding by suture).Bilateral ovarian cysts diameter and serum anti-Mullerian hormone(AMH)level before LOC,and bilateral ovarian diameter and serum AMH level 1 year after LOC were compared between two groups by Mann-Whitney U test.The Ethics Committee of Beijing Obstetrics and Gynecology Hospital approved the study protocol(approval No.2016-KY-044-01),and all the patients provided informed written consents.Results①There were no significant differences between two groups of OEC patients among age,body mass index and revised American Fertility Society(r-AFS)score(P>0.05).②There were no significant differences between two groups of OEC patients in serum AMH levels before LOC and within 1 year after LOC,as well as diameter of bilateral ovarian cysts before LOC and diameter of bilateral ovary within 1 year after LOC(P>0.05).Conclusion There are no obvious different effects of bipolar coagulation hemostasis and suture hemostasis on OR of OEC patients within 1 year after LOC.

关 键 词：子宫内膜异位症 腹腔镜 电凝术 止血 抗苗勒管激素 卵巢 卵巢囊肿 女(雌)性 

分 类 号：R71[医药卫生—妇产科学]