卵巢囊肿蒂扭转术中是否保留卵巢对卵巢储备功能的影响

目的探讨卵巢囊肿蒂扭转术中是否保留卵巢对卵巢储备功能的影响.方法回顾性分析2018年2月-2019年3月在该院拟行卵巢囊肿蒂扭转术患者(84例)的临床资料,按其是否保留卵巢分为对照组(不保留卵巢,腹腔镜下附件切除术,42例)与观察组(保留卵巢,腹腔镜下卵巢囊肿蒂扭转复位术,42例).观察两组围术期指标及住院时间;检测两组治疗前及治疗后1个月卵巢储备功能指标、血流动力学指数,记录两组并发症情况.结果两组术后3d平均体温及住院时间比较,差异无统计学意义(P>0.05);观察组手术时间、术中出血量均高于对照组(P<0.05).治疗1个月后,两组卵泡刺激素(FSH)、抗苗勒氏管激素(AMH)水平均高于治疗前,雌二醇(E2)水平、基础窦卵泡(AFC)数量、卵巢舒张末期低值流速(EDV)、卵巢收缩期峰值流速(PSV)均低于治疗前(P<0.05);观察组AMH、AFC数量、EDV、PSV水平均高于对照组(P<0.05),FSH、E2水平均低于对照组(P<0.05).术后1个月,两组阻力指数(RI)、搏动指数(PI)均高于术前,观察组低于对照组(P<0.05);观察组并发症发生率(7.14%)与对照组(9.52%)比较,差异无统计学意义(P>0.05).结论卵巢囊肿蒂扭转术中保留卵巢组织可有效保护卵巢囊肿蒂扭转患者卵巢储备功能,进而保护患者生殖和内分泌功能,且具有较高安全性.

Effect of ovary conservation on ovarian reserve function during ovarian cyst pedicle torsion

Objective To investigate the effect of ovary conservation on ovarian reserve function during ovarian cyst pedicle torsion.Methods The clinical data of patients(84 cases)with ovarian cyst pedicle torsion in the hospital from February 2018 to March 2019 were retrospectively analyzed.They were divided into control group(without ovary preservation,laparoscopic adnexectomy,42 cases)and observation group(with ovarian preservation,laparoscopic ovarian cyst pedicle torsion reduction,42 cases)according to the ovary preservation.The perioperative indexes and hospital stays in two groups were observed;The ovarian reserve function indexes and hemodynamic index in two groups before treatment and after treatment for 1 month were detected,and the complications of two groups were recorded.Results There was no statistical difference in the postoperative 3 d mean body temperature and hospital stays between two groups(P>0.05);The operation time and intraoperative bleeding volume in observation group were higher than those in control group,and the difference was statistically significant(P<0.05).After treatment for 1 month,the levels of follicle-stimulating hormone(FSH)and anti-Müllerian hormone(AMH)in two groups were higher than those before treatment,the estradiol(E2)level,antral follicle count(AFC),end diastolic velocity(EDV)and peak systolic velocity(PSV)were lower than those before treatment,the AMH,AFC,EDV and PSV in observation group were higher than those in control group,and the FSH and E2 in observation group were lower than those in control group,and the difference was statistically significant(P<0.05).The resistance index(RI)and pulsatility index(PI)in two groups after surgery for 1 month were higher than those before surgery,but observation group was lower than control group,and the difference was statistically significant(P<0.05);There was no statistical difference in the incidence of complications between observation group(7.14%)and control group(9.52%)(P>0.05).Conclusion Ovarian tissue conservation during ovarian cyst pedicle torsion can protect ovarian reserve function of patients with ovarian cyst pedicle torsion,thus protecting the reproductive and endocrine function,which has higher safety.