腹腔镜下卵巢巧克力囊肿剥除术中两种止血方法对卵巢功能的影响

目的探讨腹腔镜下卵巢巧克力囊肿剥除术中创面采用电凝和缝合两种止血方法对术后卵巢功能的影响。方法选取2001年6月至2006年8月西安市第四医院妇科收治的有手术适应证的卵巢巧克力囊肿患者68例,对腹腔镜下卵巢巧克力囊肿剥除术中创面采用电凝和缝合两种止血方法。电凝组(A组)32例,缝合组(B组)36例。所有患者术前、术后时(术后第2次月经)及术后6个月均抽血检测卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)及阴道超声探测窦状卵泡数(Fo)以判断卵巢储备功能。结果两组术后时及术后6个月时各项指标比较如下。(1)FSH:术后时A组与B组分别为(12.53±9.25)U/L和(8.57±3.40)U/L(P<0.05),术后6个月A组与B组分别为(14.44±12.15)U/L和(8.40±3.58)U/L(P<0.05)。(2)Fo:术后时A组与B组分别为(3.63±1.77)个和(5.03±1.48)个(P<0.01),术后6个月A组与B组分别为(3.56±2.06)个和(5.25±1.54)个(P<0.01)。(3)E2:术后时A组与B组分别为(213.60±42.36)pmol/L和(233.14±25.19)pmol/L(P<0.05)。(4)LH:术后6个月时A组与B组分别为(9.61±4.71)U/L和(7.79±0.71)U/L(P<0.05)。A组术后6个月时FSH≥12U/L的患者数(10例)高于B组(3例)。结论腹腔镜下卵巢巧克力囊肿剥除术中电凝止血较缝合止血易造成卵巢储备功能降低。

Influence of two hemostatic methods on ovary function in shelling out endometriotic ovary-cyst under laparosco-py

Objective To study the influence of two hemostatic methods electric coagulation and suturation on ovary function after operation in shelling out endometriotic ovarycyst under laparoscopy. Methods Totally 68 patients with endometriotic ovarycyst having operation indication were randomly chosen and divided into two groups: 32 cases for electric coagulation and 36 cases for suturation, according to hemostatic method in the operation under laparoscopy. The serum level of FSH, LH and E2 of all the cases was inspected and basal antral follicle number (Fo) was monitored through transvaginal ultrasound as judging ovary reserve function before and after operation and 6 months later. Results There was statistic significance for serum level of FSH and Fo after operation and 6 months later serum E2 level after operation and serum LH level in the 6 months of operation between two groups. The patients with serum FSH level more than 12 U/L in the group of electric coagulation were more than those in the group of suturation in the 6 months of operation. Conclusion The hemostatic method of electric coagulation is more likely to decrease ovary reserve function than suturation method during shelling out endometriotic ovary-cyst under laparoscopy.