腹腔镜下卵巢子宫内膜异位症囊肿剔除术对患者卵巢皮质剥除、卵巢功能及预后影响  

Influence of laparoscopic cystectomy for treating patients with ovarian endometriosis on their ovarian cortex removal,ovarian function,and prognosis

作　　者：姜淑丽 张欢欢 郝学平 JIANG Shuli;ZHANG Huanhuan;HAO Xueping(Hebi Hospital of Traditional Chinese Medicine, Henan Province, 458030;Hebi Maternal and Child Health Care Hospital;Hebi Jingli Hospital of Henan Province)

机构地区：[1]河南省鹤壁市中医院,458030 [2]河南省鹤壁市妇幼保健院 [3]河南省鹤壁市京立医院

出　　处：《中国计划生育学杂志》2021年第12期2546-2550,共5页Chinese Journal of Family Planning

摘　　要：目的:探究腹腔镜下卵巢子宫内膜异位症(EMs)囊肿剔除术对患者卵巢皮质剥除、卵巢功能及预后影响。方法:选择2017年3月-2020年2月本院诊治的EMs患者90例,随机抛硬币法分为腹腔镜组(47例)和开腹组(43例)分别手术治疗。比较两组卵巢皮质剥除情况,手术前后卵巢功能、性激素水平和免疫功能变化,评估患者预后。结果:腹腔镜组卵巢门皮质剥除率、卵巢中间和卵巢门皮质剥除厚度、卵巢门病灶剥除厚度均低于开腹组(P<0.05),其余部分皮质剥除厚度两组无差异(P>0.05);术后卵巢功能指标水平腹腔镜组高于开腹组(P<0.05),性激素水平两组无差异(P>0.05),两组免疫球蛋白IgM、IgA水平无差异但IgG水平腹腔镜组高于开腹组(P<0.05);术后半年内腹腔镜组复发率(6.4%)与开腹组(4.7%)无差异,但妊娠率(44.7%)高于开腹组(23.3%)(P<0.05)。结论:相比于开腹手术,腹腔镜EMs剔除术可减少对卵巢正常组织及功能的损伤,对机体免疫功能影响更小,并提高了术后妊娠率。Objective:To explore the influence of laparoscopic cystectomy for treating patients with ovarian endometriosis(EMs)on their ovarian cortex removal,ovarian function,and prognosis.Methods:90 patients with EMs who treated with surgery were selected and were divided into group A(47 cases accepted laparoscopic surgery)and group B(43 cases accepted open surgery)randomly by coin tossing method between March 2017 and February 2020.The ovarian cortex removal situation,the changes of the ovarian function,the sex hormone levels,and the immune function before and after surgery of the patients were compared between the two groups.And the prognosis of the patients in the two groups was evaluated.Results:The removal rate of ovarian hilar cortex,the removal thicknesses of ovarian middle and ovarian hilar cortex,the removal thicknesses of ovarian hilar lesions of the patients in group A were significantly lower than those of the patients in group B(P<0.05),but there were no significant differences in the removal thicknesses of other parts of the ovarian cortex of the patients between the two groups(P>0.05).After operation,the levels of ovarian function indexes of the patients in group A were significantly higher than those of the patients in group B(P<0.05),and there were no significant differences in the levels of the sex hormones of the patients between the two groups(P>0.05).There were no significant differences in the levels of immunoglobulin(IgM,IgA)of the patients between the two groups,but the level of IgG of the patients in group A was significantly higher than that of the patients in group B(P<0.05).There was no significant difference in recurrence rate(6.4%vs.4.7%)of the patients between the two groups,but the pregnancy rate(44.7%)of the patients in group A was significantly higher than that(23.3%)of the patients in group B(P<0.05).Conclusion:Compared with open surgery,laparoscopic cystectomy for threating the patients with EMs can effectively reduce the damage to their normal ovarian tissues and to their ovarian functi

关 键 词：卵巢子宫内膜异位症 腹腔镜 囊肿剔除术 卵巢皮质剥除 卵巢功能 预后 

分 类 号：R71[医药卫生—妇产科学]