腹腔镜良性卵巢囊肿剥除术对卵巢功能的影响

目的：探讨腹腔镜卵巢囊肿剥除术中使用单、双极电凝及缝合对卵巢功能的影响。方法：137例单侧卵巢良性囊肿患者,均行腹腔镜下卵巢囊肿剥除术,按不同的止血方法,将患者分为3组：单极电凝组40例、双极电凝组50例、镜下缝合组47例,分别于术前、术后3个月、术后6个月的月经第3天抽空腹血检测雌二醇（E2）、促卵泡激素（FSH）,并经阴道超声计数窦卵泡数。结果：3组病例术后3个月较术前均出现E2水平下降和FSH水平增高,窦卵泡数减少,其中单极电凝组和双极电凝组分别与术前比较有显著性差异（P〈0.05）。与镜下缝合组比较,单极电凝组和双极电凝组术后窦卵泡数以及E2、FSH均有显著差异（P〈0.05）。术后3个月双极电凝组的E2较单极电凝组高,有显著差异（P〈0.05）;术后6个月两组的E2较术后3个月增高,也有显著差异（P〈0.05）,但窦卵泡数术后6个月较术后3个月无显著差异。结论：腹腔镜下卵巢囊肿剥除创面采用电凝止血会引起对卵巢功能的损害,而使用镜下缝合止血可更好地保留其功能。

Effect of Laparoscopic Ovarian Surgery Using Different Hemostasia Methods on Ovarian Function in the Treatment of Patients with Benign Ovarian Cyst

Objective： To study the influence on the ovarian function after laparoscopic ovarian surgery using the monopolar or bipolar electrocoagulation.Methods： A total of 137 patients with benign ovarian cyst underwent laparoscopic ovarian surgery were assigned to three groups according to different hemostasia methods,the monopolar electrocoagulation group（n=40）,the bipolar electrocoagulation group（n=50） and laparotomy group（n=47）.The levels of estradiol（E2） and follicle-stimulating hormone （FSH） were measured before the operations and at 3m,6m after the operations respectively.The number of ovarian follicles were counted by transvaginal ultrasound.Results： At 3m postoperatively,the levels of E2 declined while the levels of FSH increased and the number of ovarian follicles decreased in all the 3 groups compared with those before operations respectively,and these differences in monopolar electrocoagulation group and the bipolar electrocoagulation group were statistically significant（P0.05）.Moreover,significant difference were found among the 3 groups in the levels of E2 and FSH,as well as the number of ovarian follicles in 3 m afrer operation（all P0.05）.At 6m postoperatively,the levels of E2 increased compare with those of in 3m in the monopolar electrocoagulation group and the bipolar electrocoagulation group（P0.05）,however,there was no difference for the number of ovarian follicles in these two groups（P0.05）. Conclusions：Electrocoagulation might injure the function of ovarian in the ovarian cyst surgery by laparoscope,while suture hemostasis under laparoscope can protect the ovarian function.