摘要
目的探讨不同腹腔镜术式对卵巢巧克力囊肿剥除术患者卵巢储备功能的影响。方法 2015年1月至2015年12月选取本院收治的行腹腔镜手术治疗且具有生育意愿的卵巢巧克力囊肿患者96例,根据随机数字表将患者分为观察组(n=48)及对照组(n=48),对照组行腹腔镜囊肿直接剥离术,观察组采用注水分离法剥离囊肿囊壁,比较两组患者手术时间、术中出血量、剥除病灶厚度、卵巢皮质剥除厚度及两组治疗前后内分泌激素水平的变化。对两组患者随访24个月,记录两组术后复发率、再次妊娠率。结果观察组手术时间短于对照组(P<0.05),术中出血量少于对照组(P<0.05),而剥除病灶厚度、卵巢皮质剥除厚度少于对照组(P<0.05)。观察组术后3个月、6个月卵泡刺激素(FSH)、基础黄体生成素(LH)水平较对照组明显下降(P<0.05),而雌二醇(E2)、窦状卵泡数目(Fo)较对照组明显升高(P<0.05)。观察组术后24个月复发率低于对照组(P<0.05),而自然妊娠率高于对照组(P<0.05)。结论腹腔镜术中注水分离囊肿剥离术能有效减轻手术对卵巢巧克力囊肿患者卵巢组织的损伤,保存卵巢储备功能,提高患者术后自然妊娠率,有利于患者预后。
Objective To investigate the influence of the ovarian function reservation with laparoscopic ovarian cyst excision by different separating methods in endometriotic cyst patients. Methods 96 cases with endometriotic cysts who were planned to undergo laparoscopic surgery and had a desire for fertility were divided randomly into the observation group （n=48） and the control group（n=48）from January 2015 to December 2015. The endometriotic cysts were dissected directly in the control group, and the cyst wall was separated by water injection in the observation group. Operative time, intraoperative blood loss, thickness of the resected lesion, thickness of resected ovarian cortex of the two groups were compared. The changes of endocrine hormone levels before and after treatments were compared. The postoperative recurrence rate and pregnancy rate were recorded during the 24-month follow-up. Results Operation time of the observation group was shorter than that in the control group （ P 〈0.05）.The intraoperative blood loss was less than the control group （ P 〈0.05）, and the thickness of the resected lesion and the thickness of the resected ovarian cortex were less than the control group （ P 〈0.05）. The levels of follicle estrogen （FSH）, basic luteinizing hormone （LH） and estradiol （E2） of the observation group were lower than the control group 3 months and 6 months after operation （ P 〈0.05）, and the number of antral follicles （Fo） was higher than that of the control group （ P 〈0.05）. The recurrence rate of the observation group was lower than the control group after 24 months （ P 〈0.05）, while the rate of natural pregnancy was higher than the control group （ P 〈0.05）. Conclusion The water-injection separation cystectomy in laparoscopic surgery can effectively reduce the ovarian damage in ovarian cancer cysts, preserve the ovarian function, improve the natural pregnancy rate, and is beneficial to the prognosis of the patients.
作者
王金花
李利
WANG Jin-hua;LI Li(Department of Obstetrics and Gynecology,No.302 Hospital of PLA,Beijing 100000,China)
出处
《中国现代手术学杂志》
2018年第3期201-204,共4页
Chinese Journal of Modern Operative Surgery
