CAJ | 학술논문

目的：探讨不同止血方法以及GnRH- a的使用对双侧卵巢异位囊肿剥除术后卵巢储备功能的影响。方法选择2007-06-2012-03妇科住院行腹腔镜或开腹双侧卵巢子宫内膜异位囊肿剥除手术治疗的育龄患者140例，于术前月经周期第2天、手术后1、6和12个月月经第2天抽取静脉血测定FSH、LH、E2值；根据术中止血方法将患者分为电凝组（70例）和缝合组（70例），从中选取116例根据术后是否使用GnRH- a分为GnRH- a组（58例）和对照组（58例），根据术前、术后1、6和12个月静脉血FSH、LH、E2值的变化情况来评估不同止血方法以及GnRH- a对双侧卵巢异位囊肿剥除术后卵巢储备功能的影响。结果术后1个月电凝组FSH、FSH/LH和E2水平均高于缝合组，差异均有统计学意义（均P＜0.05）；术后6个月GnRH- a组FSH、FSH/LH和E2水平分别均低于对照组，差异均有统计学意义（均P＜0.05）；术后12个月GnRH- a组患者58例中FSH恢复正常范围有55例（94.8%），对照组患者58例中FSH恢复正常46例（79.3%），前者高于后者，差异有统计学意义（P＜0.05）。结论卵巢异位囊肿剥除术中电凝止血会导致卵巢储备功能下降，术后联合GnRH- a治疗可促进卵巢储备功能的恢复。
목적：탐토불동지혈방법이급GnRH- a적사용대쌍측란소이위낭종박제술후란소저비공능적영향。방법선택2007-06-2012-03부과주원행복강경혹개복쌍측란소자궁내막이위낭종박제수술치료적육령환자140례，우술전월경주기제2천、수술후1、6화12개월월경제2천추취정맥혈측정FSH、LH、E2치；근거술중지혈방법장환자분위전응조（70례）화봉합조（70례），종중선취116례근거술후시부사용GnRH- a분위GnRH- a조（58례）화대조조（58례），근거술전、술후1、6화12개월정맥혈FSH、LH、E2치적변화정황래평고불동지혈방법이급GnRH- a대쌍측란소이위낭종박제술후란소저비공능적영향。결과술후1개월전응조FSH、FSH/LH화E2수평균고우봉합조，차이균유통계학의의（균P＜0.05）；술후6개월GnRH- a조FSH、FSH/LH화E2수평분별균저우대조조，차이균유통계학의의（균P＜0.05）；술후12개월GnRH- a조환자58례중FSH회복정상범위유55례（94.8%），대조조환자58례중FSH회복정상46례（79.3%），전자고우후자，차이유통계학의의（P＜0.05）。결론란소이위낭종박제술중전응지혈회도치란소저비공능하강，술후연합GnRH- a치료가촉진란소저비공능적회복。
Objective To investigate the impact of different hemostasis methods and gonadotropin- releasing hormone (GnRH- a) on ovarian reserved function in bilateral ovarian endometrioma after cystectomy. Methods This cohort study was conducted in 140 women with bilateral ovarian cyst,who underwent laparoscopic or laparotomic cystectomy.Based on hemostasis methods those patients were divided into two groups:electric coagulation hemostasis (n=70) and suture after excision of endometrioma(n=70). Among them 58 cases received GnRH- a treatment for 3~6 months after surgery (study group) and other 58 cases without GnRH- a were selected as control group.Serum estradiol (E2), fol icle stimulating hormone (FSH) and luteum hmTnone (LH) were measured at d 2 of menstruation cycle before and 1, 6 and 12months after surgery. Results The level of FSH, FSH/LH and E2 in electric coagulation group were higher than those in suture group after the first month of surgery(P<0.05). The level of FSH, FSH/LH and E2 were lower in GnRH- a group than those in control group after the 6th month of surgery(P<0.05) . The level of FSH returned to normal in 55 patients among 58 cases in GnRH- a group (94.8%) and in 46 cases of control group (79.3%, P<0.05). Conclusion Electric coagulation hemostasis used in cystectomy for bilateral ovarian endometrioma is associ-ated with significant decrease in ovarian reserved function. GnRH- a treatment can promote the recovery of ovarian reserve func-tion.