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目的:探讨腹腔镜下卵巢子宫内膜异位症(内异症)囊肿剥除术中不同止血方法对卵巢储备功能的影响。方法:回顾性分析因双侧卵巢内异症囊肿初次手术的80例患者临床资料,80例患者随机分为两组,术中创面止血采用单纯缝合方法 (缝合组)40例,采用电凝止血(电凝组)40例。于术前、术后第2次月经及术后6个月后第1次月经的第2～3天,分别检测患者血清卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)水平,阴道B超检测窦状卵泡数(F0)、卵巢间质动脉血流的收缩期峰值(PSV),以判断卵巢储备功能。结果:两组患者术前一般状况和卵巢储备功能比较,差异无统计学意义(P>0.05);缝合组术前、术后第2次月经及6个月后第1次月经的第2～3天的FSH、FO、PSV水平与术前比较,差异有统计学意义(P<0.05);E2水平与术前比较差异均无统计学意义(P>0.05);电凝组术前、术后第2次月经及6个月后第1次月经的第2～3天的E2、FSH、F0、PSV水平与术前比较,差异有统计学意义(P<0.05);两组术后第2次月经时、术后6个月后第1次月经的第2～3天时的雌二醇、FO、PSV水平比较,差异均有统计学意义(P<0.05)。结论:腹腔镜下双侧卵巢内异症囊肿剥除术后可能造成卵巢储备功能下降,对卵巢创面出血的处理,电凝法较单纯缝合法所致卵巢储备功能下降更加明显。
Objective: To investigate the effect of different hemostasis methods on ovarian reserve in laparoscopic ovarian endometriosis (endometriosis) cyst excision. Methods: The clinical data of 80 patients with bilateral ovarian endometriosis cyst were analyzed retrospectively. Eighty patients were randomly divided into two groups. 40 cases were treated by simple suture method (suture group) (Coagulation group) 40 cases. The serum levels of FSH, LH, and estradiol were measured before surgery, after the second menstruation and after the first 6 months after the first menstruation. E2), the number of sinus follicles detected by vaginal B-ultrasound (F0) and the systolic peak (PSV) of ovarian interstitial blood flow were measured to determine the ovarian reserve function. Results: There was no significant difference between the two groups in preoperative general status and ovarian reserve function (P> 0.05). In the suture group, the second menstruation and the second postoperative menstrual second ~ The levels of FSH, FO and PSV in 3 days were significantly different from those before operation (P <0.05), but there was no significant difference between the two groups (P> 0.05) The levels of E2, FSH, F0 and PSV in the second menstruation after the second menstruation and the first menstruation after 6 months were statistically different from those before operation (P <0.05) There were significant differences in the levels of estradiol, FO and PSV between the second menstruation and the first menstruation 6 months after the second menstruation (P <0.05). Conclusions: Laparoscopic cyst etiology of bilateral ovarian endometriosis may result in the decrease of ovarian reserve. The treatment of ovarian wound hemorrhage is more obvious than the simple suture method.