腹腔镜卵巢囊肿剥除术中电凝次数与卵巢储备功能的相关研究

目的:分析腹腔镜卵巢囊肿剥除术中电凝次数与患者卵巢储备功能的相关程度。方法:回顾分析65例接受腹腔镜卵巢囊肿剥除术患者的临床资料,根据术中电凝次数将患者分为两组,其中36例多于5次(多次组),29例不大于5次(少量组)。两组患者均于术前、术后第3个月检测血清性激素(FSH、LH、E2、T及P)浓度,并应用阴道彩超检测卵巢截面积、卵巢间质动脉血流的收缩期峰值(PSV),窦卵泡数(F0),并进行对比分析。应用Logistic回归分析电凝次数与上述各指标的相关性。结果:两组患者术前血清性激素(FSH、LH、E2、T及P)浓度及卵巢截面积、PSV与F0差异均无统计学意义(P>0.05)。与少量组相比,治疗后3个月,多次组FSH、LH浓度较高,E2浓度及卵巢截面积、PSV与F0则较低(P<0.05);而T、P两组相比差异无统计学意义(P>0.05)。Logistic回归分析显示,电凝次数与E2血清浓度呈负相关(OR=0.634,P=0.037),而与F0呈正相关(OR=2.527,P=0.022)。结论:腹腔镜卵巢囊肿剥除术中增加电凝次数可降低卵巢储备功能,应尽量减少使用次数。

The relevant analysis of electric coagulation times in laparoscopic oophorocystectomy and the ovary reserve function

Objective：To analyze the correlation between the electric coagulation times in laparoscopic oophorocystectomy and the ovary reserve function. Methods ：The clinical data of 65 patients who received laparoscopic oophorocystectomy were retrospectively analyzed. The patients were divided into two groups：many-times group （n = 36,received more than 5 times of electric coagulation） and few-times group （ n = 29, no more than 5 times of electric coagulation）. The indexes of serum levels of gonadal hormones （ such as FSH, LH, E2,T and P） were detected and the indexes of ovarian cross-sectional area, PSV and F0 were checked by vaginal Doppler sonography before operation and in postoperative 3 months. All above indexes were compared between two groups. The correlations between the electric coagulation times and the above indexes were analyzed by Logistic regression analysis. Results： The serum levels of gonadal hormones （FSH, LH,E2, T and P） and ovarian cross-sectional area, PSV and F0 were not significantly different between two groups before operation （ P 〉 0.05 ）. Compared to few-times group, the postoperative serum level of FSH, LH in many-times group were higher （ P 〈 0.05）, and the postoperative serum level of E2, the ovarian cross-sectional area, PSV and F0 in many-times group were lower （P 〈 0.05 ）, but the postoperative T and P were not different （ P 〉 0.05 ）. The times of electric coagulation was negatively correlated with E2 （ OR = 0.634, P = 0. 037 ） and positively correlated with F0 （ OR = 2. 527, P = 0.022） by Logistic regression analysis. Conclu- sions： Increase of electric coagulation times in laparoscopic oophorocystectomy can decrease the ovary reserve function. The electric co- agulation times should be as few as possiple.