腹腔镜卵巢囊肿剥除术中双极电凝止血对卵巢功能的影响(1)

http://www.100md.com 2019年5月1日 《中外女性健康研究》 20199

     【摘 要】 目的：研究腹腔鏡卵巢囊肿剥除术中双极电凝止血对卵巢功能的影响。方法：收集2015年3月至2018年1月于笔者所在医院接受腹腔镜卵巢囊肿剥除术治疗的120例患者的临床资料，依据术者所用止血方式，将患者分为两组各60例，对照组均为镜下缝合止血患者，观察组则为双极电凝止血患者，比较两组术前、术后6个月激素水平，以及术后各时间段月经改变情况、围绝经期综合征发生率差异。结果：1)两组术前雌二醇(E2)水平、促卵泡激素(FSH)水平差异无统计学意义(P>0.05)，术后6个月，观察组E2水平低于对照组，且FSH水平高于对照组，差异均具有统计学意义(P<0.05)。2)观察组手术后E2水平低于术前，且FSH水平高于术前，差异均具有统计学意义(P<0.05);而对照组术前术后激素水平无明显差异，差异无统计学意义(P>0.05)。3)观察组术后6个月月经改变率及围绝经期综合征发生率高于对照组，差异均具有统计学意义(P<0.05)。结论：腹腔镜卵巢囊肿剥除术中双极电凝止血对患者卵巢功能可造成一定损害，宜尽可能选择镜下缝合止血。

    【关键词】 腹腔镜;卵巢囊肿剥除术;双极电凝止血;卵巢功能

    [Abstract] Objective：To study the effect of bipolar electrocoagulation hemostasis on ovarian function during laparoscopic ovarian cyst excision. Methods： The clinical data of 120 patients who underwent laparoscopic ovarian cystectomy in our hospital from March 2015 to January 2018 were collected and divided into two groups according to the hemostatic method used by the operator. 60 cases in each group. The control group received suture hemostasis under laparoscope， while the observation group received bipolar electrocoagulation hemostasis. The hormone levels in the two groups before and after 6 months were compared， and the menstrual changes and the incidence of perimenopausal syndrome were observed at different time points. Results： 1)There was no significant difference in the levels of Estradiol (E2) and Follicle Stimulating Hormone (FSH) between the two groups before operation (P>0.05). At 6 months after operation， the E2 level in the observation group was lower than that in the control group， and the FSH level was higher.The difference was statistically significant (P<0.05). 2) The levels of E2 after operation in the observation group were lower than that before operation， the levels of FSH in the observation group were higher than that before operation.The difference was statistically significant (P<0.05). There was no significant difference in hormone levels before and after operation in the control group. 3) The change rate of menstruation and the incidence of perimenopausal syndrome in the observation group was higher than that in the control group at 6 months after operation .The difference was statistically significant (P<0.05). Conclusion： Bipolar electrocoagulation hemostasis during laparoscopic ovarian cystectomy may cause some damage to the ovarian function of patients， and suture hemostasis under laparoscope should be selected as far as possible.

    [Key words]Laparoscope; Ovarian cystectomy; Bipolar electrocoagulation; Ovarian function(程美萍 冷英 李洪霞)

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