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目的评价腹腔镜卵巢良性肿瘤剥除术中处理残留卵巢的不同方法对卵巢功能的影响。方法选取因双侧卵巢良性囊肿行腹腔镜下卵巢囊肿剥除术的患者90例,根据处理残留卵巢的不同方法分单极电凝组(A组)、双极电凝组(B组)和缝合组(C组),每组30例。比较各组手术前后的雌二醇(E2)、卵泡刺激素(FSH)、黄体生成素(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。3组术后均出现血清E2和AFC降低,FSH和FSH/LH增高,组间比较差异有统计学意义(P<0.05),A、B组与术前比较差异有统计学意义(P<0.05)。A、C组术后分别有8例和1例患者发生卵巢储备功能下降,差异有统计学意义(P<0.05)。结论腹腔镜下卵巢囊肿剥除术中采用单极电凝处理残留卵巢会造成卵巢功能降低,采用双极电凝法会减少对卵巢的损坏,而采用缝合法是保护卵巢功能的最佳方式。
Objective To evaluate the effect of different methods of treating residual ovary during laparoscopic benign ovarian tumor removal on ovarian function. Methods Ninety patients with laparoscopic ovarian cyst excision for benign ovarian cysts were enrolled in this study. According to different methods of residual ovary, monopolar coagulation group (group A), bipolar coagulation group (group B) and Suture group (C group), 30 cases in each group. The changes of estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH) and antral follicle count (AFC) before and after operation in each group were compared. Results All patients successfully completed the operation without any complications. Serum levels of E2 and AFC, FSH and FSH / LH were significantly decreased in all three groups (P <0.05), and there was significant difference between groups A and B before operation (P <0.05) ). In group A and group C, ovarian reserve decreased in 8 and 1 patient, respectively, with significant difference (P <0.05). Conclusion Laparoscopic treatment of ovarian cyst remnant ovarian monopolar coagulation treatment will result in reduced ovarian function, the use of bipolar coagulation will reduce the damage to the ovary, and the use of suture method is the best way to protect ovarian function.