目的：探讨腹腔镜下卵巢囊肿剔除术中缝合止血与电凝止血对卵巢功能的近期和远期影响。方法纳入2013年1月至2015年1月来我院妇科行腹腔镜卵巢囊肿剔除术治疗的子宫内膜异位囊肿患者62例，将其按照随机数字表法分为两组各31例，其中观察组术中予以缝合止血，对照组术中予以双极电凝止血，记录两组患者术前、术后1个月和术后6个月的血清卵泡刺激素(FSH)、雌二醇(E2)以及黄体生成激素（LH）水平，并用阴道超声探测窦卵泡数(F0)及卵巢间质动脉血流收缩期峰值流速(PSV)。结果术后1个月与术前比较，两组患者血清FSH、LH及E2比较差异均无统计学意义(P>0.05)；术后6个月，观察组患者血清FSH、LH、E2分别为(7.22±2.26) U/L、(5.89±2.14) U/L、(320.85±38.51) pg/mL，与术前(6.42±1.58) U/L、(5.69±2.12) U/L、(325.75±35.96) pg/mL比较差异均无统计学意义(P>0.05)，但是对照组E2为(291.88±32.14) pg/mL，较术前(321.56±35.67) pg/mL显著下降，FSH与LH水平分别为(8.99±2.12) U/L、(8.68±2.06) U/L，较术前的(6.32±1.51) U/L、(5.70±2.23) U/L显著升高，且组间比较差异有统计学意义(P>0.05)；术后6个月，观察组PSV、F0分别与术前比较差异均无统计学意义(P>0.05)，对照组F0为(4.33±1.24)个，与术前的(6.42±2.13)个比较明显减少，差异有统计学意义(P<0.05)。随访12个月，对照组合并卵巢早衰1例，观察组未发现卵巢早衰患者。结论腹腔镜下卵巢肿瘤剔除术中，采用缝合止血和电凝止血对卵巢功能近期影响相似，但从远期影响来看，电凝止血对卵巢功能影响更大，建议术中采用缝合止血。%Objective To investigate the short-term and long-term effects of suture hemostasis and coagulation and hemostasis on ovarian function in laparoscopic ovarian cyst removal. Methods A total of 62 patients with endome-trial cyst, who were enrolled in our hospital from January 2013 to January 2015 for gynecological laparoscopic ovarian cyst excision treatment, were divided into the two groups according to the random number table method, with 31 cases in each group. The patients in observation group were sutured in hemostasis, while those in the control group underwent bipolar coagulation hemostasis. Before and after 1 month and 6 months, the serum follicle stimulating hormone (FSH), estradiol (E2) and luteinizing hormone (LH) levels in the two groups were recorded, antral follicles (F0) and ovarian stro-mal artery systolic peak flow velocity (PSV) were measured by transvaginal ultrasound. Results Compared with preoper-ative, there was no significant difference between the two groups in the serum FSH, LH and E2 one month after treatment (P>0.05);Six months after treatment, the serum FSH, LH, E2 in the observation group were respectively (7.22±2.26) U/L, (5.89 ± 2.14) U/L, (320.85 ± 38.51) pg/mL, and compared with preoperative of (6.42 ± 1.58) U/L, (5.69 ± 2.12) U/L, (325.75 ± 35.96) pg/mL, the difference was not statistically significant (P>0.05). E2 in control group was (296.88 ± 32.14) pg/mL, significantly decreased compared with (321.56±35.67) pg/mL. FSH and LH levels were (8.99±2.12) U/L, (8.68±2.06) U/L, compared with preoperative (6.32±1.51) U/L, (5.70±2.23) U/L, which was significantly increased (P<0.05). Six months after treatment, PSV, F0 in the observation group showed no significant difference compared with pre-operative (P>0.05). F0 in control group (4.33±1.24) was significantly reduced compared with preoperative (6.42±2.13), P<0.05. In the 12 months of follow-up, there was 1 case of premature ovarian failure in the control group and no case of premature ovarian failure in the observation group. Conclusion In the laparoscopic ovarian cystectomy surgery, suture hemostasis and electric coagulation hemostasis have similar effect on ovarian function in the near future, but from the point of view of the long-term effects, electrocoagulation has greater efforts on ovarian function. So suture hemostasis is recommended in laparoscopic ovarian cystectomy surgery.
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