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目的对使用腹腔镜行卵巢囊肿剔除术(OCR)的双侧卵巢子宫内膜异位症(EM)患者卵巢功能和生育功能影响状况进行分析。方法选择2013年2月至2014年6月经本院收治双侧卵巢EM患者68例,随机分成研究组和对照组,各34例。对照组采用传统经腹OCR;研究组采取腹腔镜下OCR。对囊肿大小、手术时间、术中出血量进行观察并详细记录。术前及术后第2天,第1、3、6个月时对黄体生成素(LH)、雌二醇(E2)、促卵泡成熟激素(FSH)的水平进行检测记录,对患者随访1年,观察记录妊娠状况。结果研究组患者术中出血量少于对照组,手术时间短于对照组,差异有统计学意义(P均<0.05)。术前两组患者LH、E2、FSH水平比较差异无统计学意义(P均>0.05);术后研究组患者FSH及LH水平显著增加(P均<0.05);E2水平于术后第2天下降(P<0.05),术后6个月达到正常。相比较研究组患者,对照组在手术后LH、FSH水平均较低,E2水平较高(P均<0.05)。随访1年,对照组患者受孕率是47.06%(16/34),研究组患者受孕率为100%(34/34),研究组自然受孕率明显高于对照组,而人工受孕及流产率明显低于对照组,差异均有统计学意义(P均<0.05)。结论使用腹腔镜行OCR对患者正常卵巢组织破坏程度低,手术安全性较高,对患者生育功能影响较小。
Objective To analyze the influence of ovarian function and reproductive function in patients with bilateral ovarian endometriosis (EM) using laparoscopic ovarian cyst resection (OCR). Methods From February 2013 to June 2014, 68 patients with bilateral ovarian EM in our hospital were randomly divided into study group and control group, with 34 cases in each group. The control group received conventional transcranial OCR; the study group received laparoscopic OCR. Cyst size, operation time, intraoperative blood loss were observed and recorded in detail. The levels of luteinizing hormone (LH), estradiol (E2) and follicle stimulating hormone (FSH) were detected and recorded before surgery and on the second day, the first, the third and the sixth month after the operation. Year, observe and record the pregnancy status. Results The bleeding volume of the study group was less than that of the control group, the operation time was shorter than that of the control group, the difference was statistically significant (all P <0.05). There was no significant difference in LH, E2 and FSH levels between the two groups before operation (all P> 0.05). The FSH and LH levels in the study group were significantly increased (all P <0.05) Decreased (P <0.05), and reached normal 6 months after operation. Compared with the study group, the levels of LH and FSH in the control group were lower and E2 levels were higher in the control group (all P <0.05). The follow-up of 1 year, the control group, the pregnancy rate was 47.06% (16/34), the study group, the pregnancy rate was 100% (34/34), the study group, the natural conception rate was significantly higher than the control group, and artificial pregnancy and abortion rate was significantly Lower than the control group, the difference was statistically significant (P all <0.05). Conclusion The use of laparoscopic OCR in patients with normal ovarian tissue damage is low, the safety of surgery, the patient’s reproductive function less affected.