腹腔镜卵巢子宫内膜异位囊肿剥除术中的卵泡丢失

目的分析腹腔镜卵巢子宫内膜异位囊肿剥除术中的卵泡丢失情况。方法分析本院2011年1月-2012年5月因卵巢囊肿行腹腔镜囊肿剥除术患者85例，共103个卵巢囊肿石蜡切片标本。显微镜下观察囊壁形态、卵泡及卵巢组织，并进行卵泡分类计数及评分。将卵巢子宫内膜异位囊肿与卵巢非子宫内膜异位囊肿的以上各个指标进行对比，并对卵巢子宫内膜异位症患者的年龄、囊肿直径、囊壁厚度、卵泡数等指标进行相关性分析。结果卵巢子宫内膜异位囊肿卵泡总数、各级卵泡数、卵泡半定量评分及卵巢组织存在率高于卵巢非子宫内膜异位囊肿，差异有统计学意义。卵巢子宫内膜异位囊肿患者的年龄与卵泡总数之间呈负相关；囊壁厚度与卵泡总数之间呈正相关。结论腹腔镜卵巢囊肿剥除术中存在卵泡丢失，尤其是子宫内膜异位囊肿，年龄小是卵泡丢失的危险因素之一，囊壁厚度可以用来预测卵泡丢失情况。

Follicle loss during laparoscopic cystectomy for endometrioma

Objective To evaluate follicle loss in ovarian tissue after laparoscopic excision in endometrioma. Methods Cystectomy samples obtained from 103 ovaries of 85 patients by laparoscopic excision in our hospital from January 2011 to May 2012 were evaluated for histologic parameters of the capsule, follicular loss, presence of ovarian tissue and follicular semiquantitative score. All parameters from endometriomas were compared with those from nonendometriotic cysts. Correlation between age, thickness of capsule, size of cyst, and number of follicles was analyzed in all endometriotic patients. Results Number of follicles, presence of ovarian tissue, semiquantitative scoring of ovarian tissue in the endo- metriomas were significantly higher than those in the nonendometriotic cysts. There was a statistically signi？ cant inverse correlation between patient age and number of follicles in the histologic section （ r = - 0. 5, P 〈 0.01 ） and a statistically significant positive correlation between thickness of cyst capsule and number of follicles in all endometriomas （ r = 0. 3, P 〈 0. 05）. Conclusion Inadvertent ovarian follicular loss during laparoscopic cystectomy may be unavoidable, especially for endometrioma. Young age is a risk factor for follicle loss, and the thickness of the capsule may be a predictor of follicular loss.