摘要
目的：观察腹腔镜下卵巢创面两种止血方法所引起的术后卵巢功能的改变,探讨镜下卵巢囊肿手术时卵巢功能保护措施.方法：潮阳区大峰医院妇产科卵巢囊肿患者246例,完全随机分AB两组,A组为双极电凝止血组,142例;B组为缝合止血组,104例.观察两组患者在术后1、3、6个月的月经改变,检测激素水平,B超监测卵巢动脉血流参数改变、卵巢面积变化、排卵情况.结果：与术前相比,术后1个月两组均出现雌二醇（E2）水平降低,卵泡刺激素（FSH）及黄体生成素（LH）水平升高（P〈0.05）;与术后1个月比,术后3个月两组E2水平均上升,FSH、LH水平下降（P〈0.05）;睾酮（T）,孕酮（P）在术前、术后1月、术后3月均无明显变化（P〉0.05）.术后1和6个月,A组月经异常率（19%,7.0%）和B组（16.3%,5.8%）相比差异无统计学意义（P〉0.05）.但术后6个月2组月经异常率均少于术后3个月（x2=8.981,P=0.003〈0.05;x2=5.915,P=0.015）.2组术后6个月恢复排卵的比例均大于术后3个月（70.5%比42.9%;82.4%比33.3%,P〉0.05）.两组术后3个月及术后6个月忠侧卵巢基质内动脉血流参数与术前对侧卵巢基质内动脉血流参数比较均无差异（P〉0.05）.术前、术后3个月、6个月两组对侧卵巢截面积差异无统计学意义（P〉0.05）.术后3和6个月两组患侧卵巢截面积与术前对侧卵巢截面积相比差异无统计学意义.结论：腹腔镜下卵巢囊肿剔除术两种止血方式对围手术期卵巢功能影响不明显.
Objective：To detect the postoperative change in ovarian function caused by two methods for laparoseopic hemastasis of ovarian wounds and to explore the protective measures for ovarian function during laparoseopic surgery of ovarian cysts. Methods： Department of obsterics and gynecology, Dafeng Hospital of Chaoyang 246 cases of unilateral ovarian cyst were recruited and randomly divided into two groups： bipolar coagulation hemostasis group （group A,n = 142） and suture hemostasis group （group B ,n = 104）. The changes in menstruation and hormone level were detected at 1, 3 and 6 months after surgery. Moreover, type-B uhrasonound was used to examine the changes in hemodynamie parameters of ovarian artery, the size of ovary, and ovulation. Results： Both of the two groups showed a reduction in E2 level and an increase in FSH and LH levels at 1 month after surgery as compared before surgery （ P 〈 0.05 ）. At 3 months after surgery, there was an increase in E2 level and a reduction in FSH and LH levels in the both groups, contrasted significantly to the findings at 1 months after surgery （ P 〈 0.05 ）. No significant changes in testosterone （T） and progesterone （P） from baseline （before surgery） at 1 and 3 months after surgery （ P 〉 0. 05 ）. At 1 and 6 months after surgery, the rates of menstrual disorder were 19% and 7.0% in group A vs 16.3% and 5.8% in group B,which did not reach the level of significant difference （P 〉 0.05）. However, compared with the findings at 3 months after surgery, fewer patients in either group had menstrual disorder （X2 = 8. 981, P = 0. 003 〈 0. 05 ;X2 -- 5. 915, P = 0.015 ） and more showed recovery of ovulation （70.5% vs 42.9% ; 82.4% vs 33.3% ,P 〉0.05） at 6 months after surgery. There was no difference between hemodynamic parameters of ipsilateral ovarian artery of the two groups at 3 and 6 months after surgery and those of the contralateral side before surgery （ P 〉 0.05 ）. The cross-sectional area of contralateral ovary did not show statistical difference between the two groups before surgery, at 3 and 6 months after surgery （P 〉 0. 05 ）. In addition, no significant difference in cross-sectional area was found between the ipsilateral ovary at 3 and 6 months after surgery and contralateral ovary before surgery, among patients of the both group. Conclusion：There appears to be no significant impact of the two hemastasis methods in laparoscopic oophorocystectomy on perioperative ovarian function.
出处
《广州医学院学报》
2010年第6期43-48,共6页
Academic Journal of Guangzhou Medical College
关键词
腹腔镜
卵巢囊肿
手术期间
止血方式
卵巢功能
laparoscopy
ovarian cyst
intraoperative period
hemastasis method
ovarian function
