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目的 :探讨双极电凝止血、超声刀止血及缝合法止血在腹腔镜卵巢子宫内膜异位症囊肿(OEMC)剥除术中的应用对卵巢功能恢复的影响。方法 :对本院妇产科2013年5月~2015年1月采用OEMC剥除术治疗的183例患者进行回顾性分析,根据术中选择的不同止血方法进行分组,其中电凝组70例、超声刀组59例、缝合组54例,分别于术前、术后第1、3、6个月进行卵巢功能相关指标进行测量,对比三组卵巢功能恢复差异。结果 :术前电凝组、超声刀组和缝合组患者的FSH、LH、E2、AMH测定值差异均无统计学意义;术后1个月、3个月、6个月电凝组、超声刀组的FSH、E2测定值显著的高于缝合组患者,术后1个月、3个月、6个月电凝组、超声刀组的LH、AMH测定值显著的低于缝合组患者;术前电凝组、超声刀组和缝合组患者的窦状卵泡个数、PI、RI测定值差异均无统计学意义;术后6个月电凝组、超声刀组的PI、RI测定值显著的高于缝合组患者,术后6个月电凝组、超声刀组的窦状卵泡个数显著的低于缝合组患者。结论 :双极电凝止血、超声刀止血在OEMC剥除术中的应用对卵巢功能影响较大,应尽量多采用缝合法止血。
OBJECTIVE: To investigate the effect of bipolar coagulation and hemostasis, ultrasonic knife and hemostasis on the recovery of ovarian function in patients with laparoscopic ovarian endometriosis (OEMC) resection. Methods: A retrospective analysis was performed on 183 patients treated with OEMC stripping from May 2013 to January 2015 in our hospital. According to the different methods of hemostasis selected in the operation, 70 patients were treated by electrocoagulation, 59 cases of ultrasound knife group, 54 cases of suture group, respectively, before and after 1, 3, 6 months ovarian function related indicators were measured, the difference was compared between the three groups of ovarian function recovery. Results: There was no significant difference in the values of FSH, LH, E2 and AMH between the preoperative coagulation group, the ultrasound knife group and the suture group. The electrocoagulation group, ultrasound group 1 month, 3 months and 6 months after operation, The values of FSH and E2 in the knife group were significantly higher than those in the suture group. The values of LH and AMH in the electrocoagulation group and the ultrasound knife group at 1 month, 3 months and 6 months after operation were significantly lower than those in the suture group. The number of sinusoid follicles, PI and RI in preoperative coagulation group, sonicator group and suture group had no statistical significance. The values of PI and RI in the group of electrocoagulation, ultrasonic knife at 6 months after operation Significantly higher than the suture group patients, 6 months after electrocoagulation group, ultrasonic knife group, the number of sinusoids was significantly lower than the suture group patients. Conclusion: Bipolar coagulation hemostasis, ultrasonic knife hemostasis in the application of OEMC stripping greater impact on ovarian function, should be used as much as possible to stop bleeding.