腹腔镜卵巢瘤剥除术中三种止血方式对卵巢功能的影响

目的探讨腹腔镜卵巢瘤剥除术中使用双极电凝、双极电凝＋生理盐水冲洗、镜下缝合止血对卵巢功能的影响。方法 94例单侧卵巢良性肿瘤患者,均行腹腔镜卵巢肿瘤剥除术,按不同的止血方法 ,将其分为三组：双极电凝组24例、双极电凝＋生理盐水冲洗组36例、镜下缝合组34例。分别于术后3个月比较患者卵泡刺激素（FSH）、窦卵泡计数（AFC）、卵巢体积、卵巢基质血流（PSV）的变化情况。结果术后三组都出现了不同程度的窦卵泡计数、卵巢体积、卵巢基质血流速度下降和FSH增高。但双极电凝＋生理盐水冲洗组和镜下缝合组各项指标比较差异无统计学意义（P〉0.05）。双极电凝组卵巢储备功能下降明显,与双极电凝＋生理盐水冲洗组和镜下缝合组比较差异有统计学意义（P〈0.05）。结论腹腔镜下卵巢肿瘤剥除创面采用双极电凝＋生理盐水冲洗止血和镜下缝合止血对残留卵巢功能影响小,双极电凝＋生理盐水冲洗止血简便易行,是值得提倡的止血方式。

Influence of intraoperative hemostasis on the ovarian function of patients undergone laparoscopic ovariectomy

Objective To study the influence of hemostasis on the ovarian function by using the bipolar electrocoagulation, bipolar electrocoagulation with saline flushing, and laparoscopic suture respectively in laparoscopic ovariectomy. Methods A total of 94 patients with benign unilateral ovarioncus undergone laparoscope were assigned to three groups by different hemostasia methods, including bipolar electrocoagulation group （n=24）, bipolar electrocoagulation with saline flushing group （n=36） and laparoscopic suture group （n=34）. Postoperative indexes of serum follicle stimulating hormone （FSH）, antral follicle count （AFC）, mean ovarian diameters, peak systolic velocity （PSV） were analyzed in three groups. Results After the treatment, there were different levels of AFC, mean ovarian diameters, declined PSV and increased FSH in the three groups. However, there were no significant difference of the indexes between bipolar eleetrocoagulation with saline flushing group and laparoscopie suture group （P〉0.05）. The ovarian reserve function had obviously decreased in the bipolar electrocoagulation group, and it had significant difference compared with bipolar electrocoagulation with saline flushing group and laparoscopic suture group （P〈0.05）. Conclusion Bipolar eleetrocoagulation with saline flushing and laparoscopic suture methods in laparoscopic ovariectomy have less influence on ovarian reservation function. Bipolar eleCtrocoagulation with saline flushing method is more convenient than suture method, so it can be a good hemostasis way for promotion.