腹腔镜下卵巢囊肿剥除术中不同止血方式对患者免疫力及卵巢储备功能的影响  

Effects of the different hemostatic methods during the laparoscopic ovarian cystectomy of patients with ovarian cysts on their immunity and ovarian reserve function

作　　者：符芳慧 许远芳 林洁 FU Fanghui;XU Yuanfang;LIN Jie(Wanning People's Hospital,Wanning,Hainan Province,571500)

机构地区：[1]海南省万宁市人民医院,571500

出　　处：《中国计划生育学杂志》2024年第9期2034-2038,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨腹腔镜下卵巢囊肿剥除术中不同止血方式对患者机体免疫力及卵巢储备功能的影响。方法:纳入2022年10月-2023年10月本院拟行腹腔镜下卵巢囊肿剥除术患者,其中术中采用电凝止血的56例为电凝组,缝合止血56例为缝合组,对比两组手术相关指标、机体免疫功能指标(CD8+T、CD69、CD30)、卵巢基质血流及储备功能情况。结果:电凝组手术时间(54.1±2.3 min)及术中出血量(41.1±2.7ml)均低于缝合组(68.1±2.1 min、49.9±3.1ml)(均P<0.05),两组住院时间无差异(P>0.05)。术后1 d,两组CD8+T水平均降低,CD69、CD30水平均升高,但电凝组变化幅度低于缝合组;术后3个月,电凝组卵巢基质搏动指数(1.26±0.10)、阻力指数(0.78±0.07)高于缝合组(1.19±0.22、0.74±0.13),舒张期最低流速(2.57±0.18 cm/s)低于缝合组(2.93±0.31 cm/s),血清促卵泡刺激素、促黄体生成素高于缝合组,雌二醇、基质血流收缩期峰速(9.04±1.04 cm/s)及卵巢窦状卵泡数(5.57±0.68个)低于缝合组(10.98±1.01 cm/s、7.13±0.55个)(均P<0.05)。结论:在腹腔镜下卵巢囊肿剥除术中,相较于缝合止血,电凝止血手术时间更短、术中出血量更少,对患者免疫功能影响更轻,但对患者卵巢基质血流及储备功能影响相对较大。Objective:To investigate the effects of the different hemostatic methods during the laparoscopic ovarian cystectomy of patients with ovarian cysts on their immunity and ovarian reserve function.Methods:A total of 56 patients with ovarian cysts who wanted laparoscopic ovarian cystectomy were selected in this study from October 2022 to October 2023.The patients who had received electrocoagulation hemostasis during the operation were in group A and 56 patients who had received suture hemostasis during the operation were in group B.The operation related indexes,the levels of body immunity function indexes,such as CD8~+T,CD69 and CD30,the ovarian stromal blood flow and the reserve function situation of the patients were compared between the two groups.Results:The operation time(54.1±2.3 min)and the intraoperative blood loss(41.1±2.7 ml)of the patients in group A were significantly lower than those(68.1±2.1 min and 49.9±3.1 ml)of the patients in group B(all P<0.05).There was no significant difference in the hospitalization time of the patients between the two groups(P>0.05).1 day after operation,the level of CD8+T of the patients in the two groups had decreased significantly,and the levels of CD69 and CD30 of the patients in the two groups had increased significantly,but the changes of the patients in group A were significantly lower than those of the patients in group B.Three months after operation,the values of ovarian vascular matrix pulsatility index(1.26±0.10)and the resistance index(0.78±0.07)of the patients in group A were significantly higher than those(1.19±0.22 and 0.74±0.13)of the patients in group B.The ovarian vascular minimum diastolic flow velocity value(2.57±0.18 cm/s)of the patients in group A was significantly lower than that(2.93±0.31 cm/s)of the patients in group B.The levels of serum follicle-stimulating hormone and luteinizing hormone of the patients in group A were significantly higher than those of the patients in group B,and the serum estradiol level of the patients in group A was sig

关 键 词：腹腔镜下卵巢囊肿剥除术 电凝止血 缝合止血 手术指标 机体免疫力 卵巢储备功能 

分 类 号：R737.31[医药卫生—肿瘤]