经阴道后穹隆穿刺引流与腹腔镜手术治疗卵巢黄体破裂的疗效对比  

Comparison of Transvaginal Posterior Fornix Puncture and Drainage and Laparoscopic Surgery in the Treatment of Ovarian Corpus Luteum Rupture

作　　者：叶丽丽 潘越 YE Li-li;PAN Yue(Department of Emergency,Shandong Provincial Third Hospital,Jinan,Shandong 250031)

机构地区：[1]山东省立第三医院急诊科,山东济南250031 [2]淄博市第一医院妇科,山东淄博255200

出　　处：《医学临床研究》2022年第2期165-167,172,共4页Journal of Clinical Research

摘　　要：【目的】探讨经阴道后穹隆穿刺引流与腹腔镜手术治疗卵巢黄体破裂的疗效。【方法】选取2018年2月至2020年2月山东省立第三医院诊治的60例卵巢黄体破裂患者作为研究对象,按照随机数表法分为穿刺引流组(n=30)和腹腔镜组(n=30)。穿刺引流组患者采用经阴道后穹隆穿刺引流术治疗,腹腔镜组患者采用腹腔镜手术治疗。比较两组患者手术相关指标、术后疼痛情况、卵巢储备功能指标[抗苗勒管激素(Anti-Mullerian hormone,AMH)和抑制素B(Inhibin B,INHB)]及术后不良反应发生情况。【结果】穿刺引流组患者术中出血量、手术时间、住院天数及住院费用均少于腹腔镜组(P<0.05);穿刺引流组患者术后T_(1)、T_(2)、T_(3)各时间点的VAS评分均显著低于腹腔镜组(P<0.05)。术后,两组血清AMH、INHB表达水平均显著低于治疗前(P<0.05),且腹腔镜组血清AMH、INHB表达水平显著低于穿刺引流组(P<0.05)。穿刺引流组患者术后下腹疼痛、月经异常、基础体温异常、子宫出血的发生率均显著低于腹腔镜组(P<0.05)。【结论】与腹腔镜手术相比,经阴道后穹隆穿刺引流术治疗卵巢黄体破裂患者术后疼痛较轻,对卵巢储备功能影响较小,且安全性高,值得临床推广应用。【Objective】To investigate the efficacy of transvaginal posterior fornix puncture and drainage and laparoscopic surgery in the treatment of ovarian corpus luteum rupture.【Methods】A total of patients with ovarian corpus luteum rupture diagnosed and treated in the Third Hospital of Shandong Province from February 2018 to February 2020 was selected as the research objects.They were randomly divided into puncture and drainage group(n=30)and laparoscopy group(n=30).The patients in the puncture and drainage group were treated with transvaginal posterior fornix puncture and drainage,and the patients in the laparoscopic group were treated with laparoscopic surgery.The operation related indexes,postoperative pain,ovarian reserve function indexes(anti Mullerian hormone(AMH),inhibin B(INHB)and postoperative adverse reactions were compared between the two groups.【Results】The amount of intraoperative bleeding,operation time,hospitalization days and hospitalization expenses in the puncture and drainage group were less than those in the laparoscopy group(P<0.05);The VAS scores at T_(1),T_(2) and T_(3) in the puncture and the drainage group were significantly lower than those in the laparoscopy group(P<0.05).After operation,the expression levels of serum AMH and INHB in the two groups were significantly lower than those before treatment(P<0.05),and the expression levels of serum AMH and INHB in the laparoscopic group were significantly lower than those in the puncture and drainage group(P<0.05).The incidence of postoperative lower abdominal pain,abnormal menstruation,abnormal basal body temperature and uterine bleeding in the puncture and drainage group were significantly lower than those in the laparoscopy group(P<0.05).【Conclusion】Compared with laparoscopic surgery,transvaginal posterior fornix puncture and drainage in the treatment of patients with ovarian corpus luteum rupture has less postoperative pain,less impact on ovarian reserve function,and high safety,which is worthy of clinical application.

关 键 词：黄体 卵巢疾病/外科学 腹腔镜检查 治疗结果 

分 类 号：R445.12[医药卫生—影像医学与核医学]