腹腔镜下卵巢良性肿瘤剥除术中两种止血方法对卵巢储备功能的影响分析

目的探讨腹腔镜下卵巢良性肿瘤剥除术中采用双极电凝止血和缝合止血两种方法对卵巢储备功能的影响。方法50例行腹腔镜下单侧卵巢良性肿瘤剥除术患者,应用随机数表法分为A组和B组,每组25例。A组术中卵巢肿瘤剥离创面采用双极点状电凝止血,B组术中卵巢肿瘤剥离创面采用3-0可吸收线间断或连续缝合止血。比较两组患者手术前后雌二醇(E2)、卵泡刺激素(FSH)、窦卵泡数(AFC)水平。结果50例患者手术过程均顺利,无中转开腹,术后对症治疗,无术后感染及出血,按时换药,如期出院。术后1个月,两组E2、AFC水平均低于术前,FSH高于术前,且A组E2(30.33±7.28)pg/ml、AFC(4.48±1.53)个均低于B组的(34.67±7.72)pg/ml、(5.68±1.46)个,FSH(10.33±2.25)U/L高于B组的(8.82±2.40)U/L,差异均具有统计学意义(P<0.05)。术后6个月,两组的E2、FSH水平与本组术前及组间比较,差异均无统计学意义(P>0.05);B组的AFC与术前比较,差异无统计学意义(P>0.05);A组的AFC低于本组术前及B组,差异具有统计学意义(P<0.05)。结论腹腔镜下良性卵巢肿瘤剥除术中双极电凝止血法及缝合止血法均可对卵巢储备功能造成一定影响,相对电凝止血法,手术缝合止血能更好的保护卵巢功能。

Analysis of the effect of two hemostatic methods on ovarian reserve function in excision of ovarian benign tumor by laparoscopy

Objective To discuss the effect of bipolar electrocoagulation hemostasis and suture hemostasis on ovarian reserve function in excision of ovarian benign tumor by laparoscopy.Methods A total of 50 patients undergoing excision of ovarian benign tumor by laparoscopy were divided into group A and group B according to random numerical table,with 25 cases in each group.Group A received bipolar electrocoagulation hemostasis in ovarian tumor dissection wounds,and group B received 3-0 absorbable thread or continuous suture hemostasis in ovarian tumor dissection wounds.The levels of estradiol(E2),follicle stimulating hormone(FSH)and antral follicle count(AFC)before and after operation were compared between the two groups.Results All the 50 patients had a smooth operation,no conversion to laparotomy,symptomatic treatment after operation,no postoperative infection or bleeding,and all of them were discharged on schedule after dressing change on time.1 month after operation,E2 and AFC were all lower than those before operation,and FSH was higher than that before operation.The E2(30.33±7.28)pg/ml and AFC(4.48±1.53)follicles of group A were all lower than(34.67±7.72)pg/ml and(5.68±1.46)follicles,and FSH(10.33±2.25)U/L was higher than(8.82±2.40)U/L of group B.The difference was statistically significant(P<0.05).At 6 months after operation,the levels of E2 and FSH in the two groups had no statistically significant difference compared with those before operation and between the two groups(P>0.05);the AFC in group B had no statistically significant difference compared with that before operation(P>0.05);the AFC in group A was lower than that before operation and in group B,and the difference was statistically significant(P<0.05).Conclusion Bipolar electrocoagulation hemostasis and suture hemostasis can show certain effect on ovarian reserve function in excision of ovarian benign tumor by laparoscopy.Compared with electrocoagulation hemostasis,surgical suture hemostasis can better protect ovarian function.