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目的:探讨腹腔镜不孕症手术中使用单、双极电凝对卵巢功能的影响。方法:选择100例因输卵管因素导致的不孕症患者,均行腹腔镜下输卵管的修复整形手术,使用不同的止血方法随机分为单极电凝组50例、双极电凝组50例。分别于术前、术后1、3个月抽血检测促卵泡激素(FSH)、黄体生成素(LH)、雌二醇(E2),月经第11天开始B超监测排卵情况,术后随访1年。结果:两组病例术后1、3个月较术前均出现不同程度的FSH、LH增高和E2下降,单极电凝组与术前比较差异有统计学意义(P<0.05),双极电凝组与术前比较差异无统计学意义(P>0.05)。结论:腹腔镜下不孕症手术中使用单、双极电凝止血会引起对卵巢功能的损害,而使用单极电凝止血对卵巢功能的损害较使用双极电凝止血大。单极电凝组术后发生月经改变明显多于双极电凝组(P<0.05)。双极电凝组术后妊娠率较单极电凝组高。
Objective: To investigate the effect of single and bipolar coagulation on ovarian function in laparoscopic infertility surgery. Methods: 100 cases of infertility due to fallopian tube were selected for laparoscopic salpingoplasty. Fifty cases of monopolar coagulation and 50 cases of bipolar coagulation were randomly divided into two groups according to different methods of hemostasis. The levels of FSH, LH and E2 were measured before and 1 and 3 months after operation respectively. The ovulation was monitored by B-ultrasound on the 11th day of menstruation. The postoperative follow-up 1 year. Results: The levels of FSH, LH and E2 decreased in both groups at 1 and 3 months after operation compared with that before operation. There was a significant difference between pre-coagulation group and pre-coagulation group (P <0.05) There was no significant difference between the electrocoagulation group and preoperative (P> 0.05). Conclusions: Single and bipolar coagulation in laparoscopic infertility surgery can cause damage to ovarian function. However, the use of unipolar coagulation to hemostat ovarian function is more impaired than bipolar coagulation. Monopolar coagulation group had significantly more menstrual changes than bipolar coagulation group (P <0.05). Postoperative pregnancy rate in bipolar coagulation group was higher than that in monopolar coagulation group.