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目的:探讨腹腔镜处理输卵管积水的不同方式对卵巢储备的影响及可能机制。方法:选取因输卵管积水不孕行腹腔镜处理积水的患者111例,分3组:造口组(A组,n=48)、离断组(B组,n=33)、切除组(C组,n=30);另选取因其它原因行腹腔镜检的无输卵管积水患者为对照组(D组,n=20),比较各组手术前、后的卵巢储备情况。结果:A、B、C组患者术后2～6mm窦卵泡数、B组术后卵巢动脉RI均低于术前,有统计学差异(P<0.05),D组手术前、后各指标无差异。术后A、B、C组间卵巢动脉RI比较均有差异(P<0.05),其中B组均值最低;余各指标无统计学差异。结论:输卵管积水会降低卵巢储备,腹腔镜处理积水的3种术式均可在近期改善卵巢储备,其中,离断术可能是最有利于术后近期卵巢储备改善的术式。
Objective: To investigate the effects of different modes of laparoscopic treatment of ovarian reserve on ovarian reserve and its possible mechanism. Methods: One hundred and eleven patients with laparoscopic hydronephrosis treated by hydronephrosis were selected and divided into three groups: the ostomy group (group A, n = 48), the disconnection group (group B, n = 33), the resection group (Group C, n = 30). Patients without tubal hydronephrosis who underwent laparoscopy for other reasons were selected as the control group (group D, n = 20). The ovarian reserve in each group was compared before and after operation. Results: The number of antral follicles of 2 ~ 6mm after operation in group A, B and C was significantly lower than that before operation in group B (P <0.05), and the index of before and after operation in group D difference. The RI of ovarian artery in groups A, B and C after operation were all significantly different (P <0.05), among which the mean of group B was the lowest; Conclusion: Hydrosalpinx can reduce ovarian reserve, and laparoscopic treatment of hydrocephalus can improve ovarian reserve in the near future. Among them, resection may be the most favorable operative procedure for improving ovarian reserve.