腹腔镜下电凝和缝合止血对残留卵巢储备功能影响的对比研究

摘要

目的:对比研究腹腔镜下卵巢囊肿剥除术中残留卵巢创面采用双极电凝和缝合止血方法对卵巢储备功能的影响.方法:双侧卵巢囊肿患者90例,卵巢囊肿均位于卵巢门部位以外.随机分为电凝组(45例)和缝合组(45例).比较两组患者术后的血清E2、FSH、LH以及窦卵泡计数(AFC)的变化情况.结果:全部患者均顺利完成手术,术中未发生任何并发症.两组患者术后与术前比较,E2和AFC均显著下降,FSH显著升高,差异均有统计学意义(P＜0.05),而LH差异无统计学意义(P＞0.05).两组患者术后组间比较,E2、FSH以及AFC差异无统计学意义(P＞0.05).两组术后均有1例患者新发生卵巢储备功能下降,均无卵巢功能衰竭病例发生.结论:对囊肿位于卵巢门部位外的卵巢囊肿患者,腹腔镜下卵巢囊肿剥除术中,残留卵巢创面采用双极电凝和缝合止血方法对卵巢功能影响无明显差异.%Objective:To study the influence of bipolar electric coagulation and suture hemostasis managing residual ovarian parenchyma on ovarian reservation function in laparoscopic oophorocystectomy. Methods: 90 patients with both ovarian cysts which located outside of hilum of ovary were divided randomly into bipolar electric coagulation group (45 cases) and suture group (45 cases). Postoperative serum estradiol (E2), follicle stimulating hormone(FSH), luteinizing hormone(LH), antral follicle count( AFC)with preoper-ative index were analyzed in two groups. Results: All the surgeries were accomplished successfully under laparoscopy and no complication happened. Comparing with preoperation, the postoperative levels of E2 and AFC decreased,postoperative FSH were increased in all patients,there were significant differences betweenrntwo groups (P <0.05), but there was no significant difference in the postoperative levels of LH between these two groups(P>0.05). Comparing with two groups after operation, there was no significant difference in level of E2, FSH and AFC(P>0.05). There was 1 case whose ovarian reserve function had decreased in each group,the difference was not significant (P>0.05), there was no ovarian reserve function failure in two groups. Conclusions:For ovarian cyst locating in outside of hilum of ovary, There is no obvious influence for bipolar electric coagulation and suture hemostasis managing residual ovarian parenchyma on ovarian reservation function in laparoscopic oophorocystectomy.