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目的对腹腔镜下卵巢双侧囊肿切除术后双极电凝与传统缝合止血方法进行研究,评价两种止血方法对卵巢储备功能的影响。方法将2014年1月至2016年3月在广东医科大学附属高明医院就诊的卵巢双侧囊肿患者80例,根据手术处理方法的不同分成A、B两组,每组40例;A组采用传统腹腔镜手术方式切除病变卵巢囊肿并缝合术处理卵巢残端,B组行腹腔镜下卵巢囊肿切除术并双极电凝处理创口;用酶联免疫吸附试验分别于术前及术后1月、3月测定患者抗苗勒氏管激素(anti-Müllerian hormone,AMH)含量,所有患者均采用经阴道彩色超声检查窦卵泡数量(antral follicle number,AFC)。比较两组各监测数据的变化并与正常育龄妇女40例(C组)进行对照。结果 3组术前及术后3月AMH含量比较差异无统计学意义(P>0.05),术后1月A、B两组AMH含量显著降低(P<0.05);A、B两组术前及术后3月比较,AMH含量差异无统计学意义(P>0.05),术后1月AMH含量差异有统计学意义(P<0.05);A组术前与术后各时期卵巢AFC比较,差异无统计学意义(P>0.05);B组术后1、3月与术前比较AFC差异有统计学意义(P<0.05);术后1月A、B组间比较,AFC差异有统计学意义(P<0.05)。结论卵巢囊肿双侧切除术对卵巢功能有一过性影响,双侧电凝止血方式影响更大,应谨慎使用。
OBJECTIVE To study the methods of bipolar coagulation and traditional suture hemostasis after laparoscopic ovarian bilateral cyst excision to evaluate the effect of two hemostatic methods on ovarian reserve. Methods From January 2014 to March 2016, 80 patients with bilateral ovarian cyst treated at Gaoming Hospital Affiliated to Guangdong Medical University were divided into two groups according to the method of surgical treatment: group A and group B, 40 cases in each group. Group A Laparoscopic surgical removal of diseased ovarian cysts and suture treatment of ovarian stump, B group laparoscopic ovarian cyst resection and bipolar coagulation treatment of wounds; enzyme-linked immunosorbent assay in preoperative and postoperative January, In March, anti-Müllerian hormone (AMH) levels were measured in all patients. Antral follicle number (AFC) was examined by transvaginal sonography. The changes of monitoring data in two groups were compared and compared with 40 normal women of childbearing age (group C). Results There was no significant difference in AMH content between the three groups before and after 3 months (P> 0.05). The AMH content of A and B groups decreased significantly after 1 month (P <0.05) (P> 0.05). There was a significant difference in AMH content between January and January after operation (P <0.05). The AFC of ovary in group A before and after operation was significantly higher than that in group A There was no significant difference between the two groups (P> 0.05). There was significant difference in AFC between January and March after operation in group B (P <0.05) Significance (P <0.05). Conclusions Bilateral ovarian cyst excision has a transient effect on ovarian function. Bilateral electrocoagulation is more influential in hemostasis and should be used with caution.