两种止血法对腹腔镜卵巢囊肿剥除术卵巢储备功能的影响

目的探讨腹腔镜下卵巢囊肿剥除术中创面采用双极电凝和缝合2种止血方法对术后卵巢储备功能的影响.方法选取行腹腔镜卵巢囊肿剥除的患者80例,对腹腔镜下卵巢囊肿剥除术后创面采用双极电凝和缝合两种止血方法.双极电凝组（A组）40例,缝合组（B组）40例.所有患者术前、术后1个月（术后第2次月经）及3个月分别抽血检测卵泡刺激素（FSH）、黄体生成素（LH）、雌二醇（E2）、血清基础抑制素B（INHB）及阴道超声探测窦状卵泡数（AFC）以判断卵巢储备功能.结果两组病例在术后1月均出现E2、INHB下降及FSH、LH增高,阴道超声探测AFC分别与术前比较差异有统计学意义（P〈0.05）,电凝止血组与镜下缝合组术后3个月E2、INHB、FSH、LH、阴道超声探测AFC的比较差异有统计学意义（P〈0.05）.结论腹腔镜下卵巢囊肿剥除术后双极电凝止血易造成卵巢储备功能降能降低,这种电凝止血方法较缝合止血方法加重对卵巢储备功能的损伤.

The Influence of Two Hemostatic Methods on the Ovarian Reserve Function after Laparoscopic Cystectomy for Ovarian Cyst

Objective To study the influence of the bipolar electrocoagulation and suture hemostasis respectively on the ovarian reserve function after laparoscopic cystectomy for ovarian cyst.Methods Eighty patients with ovarian cyst who underwent laparoscopic cystectomy were randomly divided into two groups：bipolar electrocoagulation group,（A group）and suture group,（B group）,40 cases in each group.Patients in A group received bipolar electrocoagulation for hemostasis,and patients in B group received suture for hemostasis.The serum levels of FSH,LH,E2,and INHB were detected respectively before the operations and 1 month,（the second menstrual cycle after operation）and 3 months after operation,and basal antral follicle count,（AFC） was detected by transvaginal B ultrasonography to determine the ovarian reserve.Results The serum levels of E2,INHB declined and those of FSH and LH increased in two groups 1 month after operation,basal antral follicle count,（AFC）was detected by transvaginal B ultrasonography.There was a significant difference in the indices between before and after operation,（P0.05）.There was a significant difference in the levels of E2,INHB,FSH,LH,and AFC 3 months after operation between bipolar electrocoagulation group and suture group.Conclusion The bipolar electrocoagulation hemostasis after laparoscopic cystectomy for ovarian cyst can decrease the ovarian reserve function,and it can aggravate the damage of the ovarian reserve function compared with the suture hemostasis.