育龄期卵巢囊肿蒂扭转患者保留卵巢功能术后血清AMH水平的变化  

Changes of serum AMH levels in patients with ovarian cyst torsion at childbearing age after preserving ovarian function surgery

作　　者：谢宝丽[1] 黄建邕[1] 庞光连[1] XIE Bao-li;HUANG Jian-yong;PANG Guang-lian(The First People’s Hospital of Nanning,Nanning520025)

机构地区：[1]南宁市第一人民医院,南宁520025

出　　处：《生殖医学杂志》2023年第8期1172-1176,共5页Journal of Reproductive Medicine

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20201403)。

摘　　要：目的评估卵巢囊肿蒂扭转保留卵巢功能术后卵巢储备功能是否降低和恢复,并探讨术中扭转卵巢肉眼所见坏死程度对抗苗勒管激素(AMH)水平变化的影响。方法收集2021年1月至2022年9月在我院行腹腔镜下卵巢囊肿蒂扭转复位+囊肿剥除治疗的患者(实验组,n=20)的临床资料,另收集同期育龄期卵巢良性肿瘤行腹腔镜下卵巢肿瘤剔除术的患者为对照组(n=25)。两组患者均于术前、术后1周、1个月、3个月时检测血清AMH水平,比较两组患者的一般资料及不同时间点的AMH水平。又以术中是否存在明显肉眼可见的组织坏死将实验组分为坏死组和无坏死组,比较两组术后3个月窦卵泡数、术前和术后3个月的AMH水平。结果两组患者的年龄及体质量指数(BMI)均无显著性差异(P>0.05);实验组术前的AMH水平显著低于对照组[(3.4±2.1)ng/ml vs.(5.9±3.5)ng/ml,P=0.007]。与术前相比,实验组术后1周血清AMH水平呈下降趋势,但差异无统计学意义(P>0.05);术后1个月AMH水平有所恢复,术后3个月时AMH水平超过术前,术后3个时间点的AMH水平变化均无显著性差异(P>0.05)。对照组术后1周血清AMH水平低于术前,但尚无显著性差异(P=0.478);术后1个月时AMH水平有所回升,但术后3个月时AMH水平仍低于术前,术后不同时间点的AMH水平变化亦无显著性差异(P>0.05)。实验组与对照组间的术后1周、1个月及3个月AMH水平比较均无显著性差异(P>0.05)。实验组中坏死组和无坏死组术前AMH、术后3个月的窦卵泡数及AMH水平均无显著性差异(P>0.05)。结论卵巢囊肿蒂扭转可能导致卵巢功能下降,保留卵巢功能的术式安全可行,术后卵巢功能可在一定程度上有所恢复。Objective:To evaluate whether the ovarian reserve function is reduced and restored after the preserving ovarian function surgery for ovarian cyst torsion,and to explore the effect of gross necrosis of torsion ovary on the change of anti-Mullerian hormone(AMH)level during the operation.Methods:The clinical data of the patients who received laparoscopic ovarian cyst pedicle torsion reduction+cyst removal treatment in our hospital from January 2021 to September 2022 were collected(experimental group,n=20),and the patients with benign ovarian tumors at reproductive age who received laparoscopic ovarian tumor removal during the same period were collected as the control group(n=25).Serum AMH levels in two groups were detected before surgery,1 week,1 month and 3 months after surgery.The general data and AMH levels at different time points were compared between two groups.The experimental group was divided into necrotic group and non-necrotic group based on whether there was obvious visible tissue necrosis during surgery.The number of antral follicles at 3 months after surgery and the levels of AMH before and 3 months after surgery were compared between the two groups.Results:There were no significant differences in age and body mass index(BMI)between the two groups(P>0.05).Compared with the control group,the AMH level in the experimental group before surgery decreased significantly[(3.4±2.1)ng/ml vs.(5.9±3.5)ng/ml,P=0.007].Compared with the pre-operation,the serum AMH level in the experimental group showed a decreasing trend one week after surgery,but the difference was not significant(P>0.05).AMH level recovered 1 month after surgery,and AMH of 3 months after surgery was higher than before surgery.However,there was no significant difference in AMH level at 3 time points after surgery(P>0.05).The serum AMH level at 1 week after surgery in the control group was lower than that before surgery(P=0.478),and the AMH level increased at 1 month,but which was still lower at 3 months after surgery.There were no significant dif

关 键 词：卵巢囊肿蒂扭转 抗苗勒管激素 窦卵泡 育龄期 

分 类 号：R711.75[医药卫生—妇产科学]