CAJ | 학술논문

【目的】探讨腹腔镜下卵巢囊肿剥离中不同止血方式对卵巢功能影响。【方法】卵巢子宫内膜囊肿患者66例，均行腹腔镜下囊肿剥除术，并将其分成两组：镜下缝合组36例、电凝组30例，观察两组术前、术后6个月性激素雌二醇（E2）、卵泡刺激素（FS H ）、黄体生成激素（L H ）水平及窦状卵泡数、卵巢功能正常例数及卵巢储备功能下降例数。【结果】术前两组卵巢功能正常率和卵巢储备功能下降率比较差异无统计学意义（ P ＞0．05）；术后缝合组卵巢功能正常率83．33％（30/36）显著高于电凝组53．33％（16/30）（ P ＜0．05），而卵巢储备功能下降率16．67％（6/36）显著低于电凝组46．67％（14/30）（ P＜0．05）。缝合组E2、窦状卵泡数分别为（198．4±24．90）pmol/L、（7．13±2．25）个显著高于电凝组（153．40±16．8）pmo/L、（5．8±0．9）个（ P＜0．05），而FSH和FSH/LH分别为（10．56±4．56）U/L、2．35±1．26显著低于电凝组（13．72±2．81）U/L、（2．82±0．88）U/L （ P ＜0．05）。【结论】腹腔镜下卵巢保守性手术中，正确的镜下缝合止血与传统电凝术相比，对卵巢组织损伤更小，可更好地保留其功能。
【목적】탐토복강경하란소낭종박리중불동지혈방식대란소공능영향。【방법】란소자궁내막낭종환자66례，균행복강경하낭종박제술，병장기분성량조：경하봉합조36례、전응조30례，관찰량조술전、술후6개월성격소자이순（E2）、란포자격소（FS H ）、황체생성격소（L H ）수평급두상란포수、란소공능정상례수급란소저비공능하강례수。【결과】술전량조란소공능정상솔화란소저비공능하강솔비교차이무통계학의의（ P ＞0．05）；술후봉합조란소공능정상솔83．33％（30/36）현저고우전응조53．33％（16/30）（ P ＜0．05），이란소저비공능하강솔16．67％（6/36）현저저우전응조46．67％（14/30）（ P＜0．05）。봉합조E2、두상란포수분별위（198．4±24．90）pmol/L、（7．13±2．25）개현저고우전응조（153．40±16．8）pmo/L、（5．8±0．9）개（ P＜0．05），이FSH화FSH/LH분별위（10．56±4．56）U/L、2．35±1．26현저저우전응조（13．72±2．81）U/L、（2．82±0．88）U/L （ P ＜0．05）。【결론】복강경하란소보수성수술중，정학적경하봉합지혈여전통전응술상비，대란소조직손상경소，가경호지보류기공능。
Objective To explore the influence of different hemostatic methods on ovarian function in o-varian endometriotic cyst undergoing laparoscopic cystectomy .[Methods] Totally 66 patients with ovarian en-dometriotic cyst underwent laparoscopic cystectomy .All patients were divided into microscopic suture group ( n =36) and electrocoagulation group( n=30) .Estradiol(E2 ) ,follicle stimulating hormone(FSH) ,luteini-zing hormone(LH) ,the number of sinusoidal follicles ,normal ovarian function and the declined ovarian re-serve function in two groups were observed before and 6 months after operation .[Results]There was no signif-icant difference in the normal rate of ovarian function and the declining rate of ovarian reserve function before operation bwteem two groups( P>0 .05) .After operation ,the normal rate of ovarian function in suture group was markedly higher than that in electrocoagulation group [83 .33% (30/35) vs 53 .33% (16/30)]( P<0 .05) , but the declining rate of ovarian reserve function was markedly lower than that in electrocoagulation group [16 . 67% (6/36) vs .46 .67% (14/30)]( P<0 .05) .The E2 and number of sinusoidal follicles in suture group were (198 .4 ± 24 .90)pmol/L and (7 .13 ± 2 .25) ,which were markedly higher than those in electrocoagulation group[(153 .40 ± 16 .8)pmo/L and (5 .8 ± 0 .9)]( P<0 .05) .FSH and FSH/LH in suture group were (10 .56 ± 4 .56)U/L and (2 .35 ± 1 .26) ,which were markedly lower than those in electrocoagulation group [(13 .72 ± 2 .81)U/L and (282 ± 0 .88)U/L]( P <0 .05) .[Conclusion] During laparoscopic ovarian conservation opera-tion ,correct microscopic suture hemostasis has smaller ovarian injury and can better reserve ovarian function than routine electrocoagulation .