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目的比较腹腔镜卵巢囊肿剔除术中不同止血方式对卵巢功能的影响。方法 106例卵巢囊肿患者根据腹腔镜卵巢囊肿剔除术中止血方式分为缝合组(n=56)和电凝组(n=50),术后进行6个月的随访,观察两组患者月经和排卵情况及激素水平,并行彩超检查患者卵巢间质动脉血流收缩期峰值流速(PSV)、窦卵泡数及卵巢大小。结果缝合组患者恢复排卵的比例为82.1%,明显高于对照组的64.0%,差异有统计学意义(P<0.05)。术后6个月,缝合组患者血清促卵泡成熟激素(FSH)、促黄体生成素(LH)、雌二醇(E2)水平与术前比较,差异无统计学意义(P>0.05);但电凝组术后6个月的FSH及LH水平明显高于术前,E2明显低于术前,与缝合组差异均有统计学意义(P<0.05)。电凝组患者窦卵泡数较术前明显减少,且明显低于缝合组,差异有统计学意义(P<0.05)。结论腹腔镜卵巢囊肿剔除术中采用缝合止血比电凝止血法更有利于保护患者的卵巢功能。
Objective To compare the effects of different hemostatic methods on ovarian function during laparoscopic ovarian cyst excision. Methods One hundred and six patients with ovarian cysts were divided into suture group (n = 56) and electrocoagulation group (n = 50) according to the method of hemostasis during laparoscopic ovarian cyst excision. The patients were followed up for 6 months. Ovulation and hormone levels, parallel flow ultrasound examination of ovarian interstitial artery blood flow peak systolic velocity (PSV), antral follicles and ovarian size. Results The percentage of ovulation recovery in the suture group was 82.1%, which was significantly higher than 64.0% in the control group (P <0.05). Six months after operation, the levels of FSH, LH and E2 in the suture group were not significantly different from those in the preoperative group (P> 0.05); however, The levels of FSH and LH in the electrocoagulation group at 6 months after operation were significantly higher than those before operation, and E2 was significantly lower than those before operation (P <0.05). The number of antral follicles in patients with electrocoagulation was significantly lower than that before operation, and was significantly lower than that of the suture group (P <0.05). Conclusion Laparoscopic ovarian cyst resection surgery using suture hemostasis is more conducive to the protection of patients with ovarian function than coagulation.