腹腔镜卵巢囊肿剔除术对卵巢功能的影响

目的探讨腹腔镜下不同卵巢良性囊肿剔除手术对女性卵巢功能的影响。方法 2004年9月~2008年3月在我院接受腹腔镜卵巢囊肿剔除术的卵巢良性肿瘤114例,包括单侧卵巢内膜异位囊肿剔除33例,双侧卵巢内膜异位囊肿剔除22例,单侧卵巢囊肿剔除(除卵巢内膜异位囊肿)48例,双侧卵巢囊肿剔除(除卵巢内膜异位囊肿)11例,测定术前、术后3个月血清促卵泡素(FSH)、促黄体生成素(LH)和雌二醇(E2),术后3个月随访月经情况、潮热症状。结果与各组术前相比,4组术后3个月性激素水平变化的差异无显著性(P0.05)。4组间术前性激素水平差异无显著性(P0.05),术后FSH、FSH/LH、E2水平4组间差异无显著性(P0.05)。术后LH水平单侧卵巢内膜异位囊肿剔除组明显低于双侧卵巢内膜异位囊肿剔除组和单侧卵巢囊肿剔除组(P值分别为0.0003、0.0191),术后LH水平双侧卵巢囊肿剔除组低于双侧卵巢内膜异位囊肿组(P=0.0479),其余组间未见显著性差异(P0.05)。术后3个月共有10例(8.8%)月经异常,5例(4.4%)潮热盗汗。61例有生育要求者中共有26例(42.6%)妊娠。结论腹腔镜下不同卵巢良性囊肿剔除手术对女性卵巢功能的近期影响有限。

Effect of Laparoscopic Ovarian Cystectomy on Ovarian Function

Objective To study the influence of different ovarian surgical procedures on the ovarian function and thus to improve laparoscopic techniques. Methods From September 2004 to March 2008,totally 114 patients with benign ovarian cyst,including 33 cases of unilateral ovarian endometriotic cyst（UOE group）,22 cases of bilateral ovarian endometriotic cyst（BOE group）,48 cases of unilateral ovarian non-endometriotic cyst（UON group）,and 11 cases of bilateral ovarian non-endometriotic cyst（BON group）.The serum levels of E2,FSH,and LH,as well as menstruation and symptoms of the patients were observed 1 month pre-operationally and 3 months after the operation. Results In none of the four groups,the levels of sexhormone increased significantly three months after the operation（P0.05）.No significant difference was detected either in the levels of sexhormone among the four groups before the operation（P0.05） or in the levels of E2,FSH,and FSH/LH postoperation.Whereas,the postoperative level of LH in the UOE group was significantly lower than that in the BOE and UON groups（P=0.0003 and 0.0191 respectively）;furthermore,the postoperative level of LH in the BON group was significantly lower than that in the BOE group（P=0.0479）.In three months after the treatment,10 patients（8.8%） showed abnormal menstruation,5 patients（4.4%） complained of hot flash and night sweat.In the 114 patients,61 women had desire to give birth,26 of them（42.6%） got pregnant in three months after the operation. Conclusion Laparoscopic procedures have limited influence on ovarian function.