CAJ | 학술논문

目的：探讨腹腔镜卵巢囊肿剔除术中不同止血方式对性激素及抗苗勒管激素（ AMH）等的影响。方法选择良性卵巢囊肿患者126例，随机分为电凝止血组（43例）、缝合止血组（46例）、压迫止血组（37例），评估3种止血方法对性激素水平、抗苗勒管激素、窦卵泡数、卵巢早衰的影响。结果电凝止血组术后卵泡刺激素、黄体生成激素、雌二醇较术前有显著性升高（t值分别为5．738、6．762、7．084，均P＜0．05），缝合止血组黄体生成激素较术前有显著性升高（t＝6．761，P＜0．05）。缝合止血组术后卵泡刺激素、黄体生成激素、雌二醇较电凝止血组术后有显著性下降（t值分别为5．804、7．732、6．774，均P＜0．05）；压迫止血组术后卵泡刺激素、黄体生成激素、雌二醇较电凝止血组术后有显著性下降（t值分别为6．726、6．347、7．083，均P＜0．05）。电凝止血组术后抗苗勒管激素、窦卵泡数较术前有显著性下降（t值分别为5．762、4．526，均P＜0．01），缝合止血组、压迫止血组术后抗苗勒管激素较术前有显著性下降（t值分别为6．562、5．184，均P＜0．05）。缝合止血组术后窦卵泡数较电凝止血组术后有极显著性增加（t＝8．749，P＜0．01），压迫止血组术后抗苗勒管激素、窦卵泡数较电凝止血组术后有显著性升高（t值分别为7．194、5．837，均P＜0．05）。3组卵巢早衰发生率有显著性差异（χ2＝9．847，P＜0．05）。结论腹腔镜卵巢囊肿剔除术中采用缝合止血、压迫止血法更易保护卵巢储备功能，其中压迫止血法效果更好，但应注意病例的选择。
목적：탐토복강경란소낭종척제술중불동지혈방식대성격소급항묘륵관격소（ AMH）등적영향。방법선택량성란소낭종환자126례，수궤분위전응지혈조（43례）、봉합지혈조（46례）、압박지혈조（37례），평고3충지혈방법대성격소수평、항묘륵관격소、두란포수、란소조쇠적영향。결과전응지혈조술후란포자격소、황체생성격소、자이순교술전유현저성승고（t치분별위5．738、6．762、7．084，균P＜0．05），봉합지혈조황체생성격소교술전유현저성승고（t＝6．761，P＜0．05）。봉합지혈조술후란포자격소、황체생성격소、자이순교전응지혈조술후유현저성하강（t치분별위5．804、7．732、6．774，균P＜0．05）；압박지혈조술후란포자격소、황체생성격소、자이순교전응지혈조술후유현저성하강（t치분별위6．726、6．347、7．083，균P＜0．05）。전응지혈조술후항묘륵관격소、두란포수교술전유현저성하강（t치분별위5．762、4．526，균P＜0．01），봉합지혈조、압박지혈조술후항묘륵관격소교술전유현저성하강（t치분별위6．562、5．184，균P＜0．05）。봉합지혈조술후두란포수교전응지혈조술후유겁현저성증가（t＝8．749，P＜0．01），압박지혈조술후항묘륵관격소、두란포수교전응지혈조술후유현저성승고（t치분별위7．194、5．837，균P＜0．05）。3조란소조쇠발생솔유현저성차이（χ2＝9．847，P＜0．05）。결론복강경란소낭종척제술중채용봉합지혈、압박지혈법경역보호란소저비공능，기중압박지혈법효과경호，단응주의병례적선택。
Objective To explore the influence of different ways of intraoperative hemostasis during laparoscopic ovarian cystectomy for ovarian reserve function on sex hormone and anti-miillerian hormone (AMH).Methods Totally 126 cases of benign ovarian cysts were chosen and they were randomly divided into electric coagulation group ( n =43 ) , suture hemostatic group ( n =46 ) and oppression hemostasis group (n=37).The influence of three kinds of hemostasis methods on sex hormone level , AMH, sinus follicle number and premature ovary failure was assessed.Results Postoperative FSH, LH and E2of the electric coagulation group were improved significantly (t value was 5.738, 6.762 and 7.084, respectively, all P<0.05), while LH of the suture hemostatic group increased significantly (t=6. 761, P<0.05).FSH, LH and E2 of the suture hemostatic group decreased remarkably compared with those of the electric coagulation group (t value was 5.804, 7.732 and 6.774, respectively, all P<0.05), and FSH, LH and E2 of the oppression hemostasis group decreased significantly compared with those of the electric coagulation group (t value was 6.726, 6.347 and 7.083, respectively, all P<0.05).AMH, sinus follicle number of the electric coagulation group had significant decrease after operation (t value was 5.762 and 4. 526, respectively, both P<0.01), and AMH in the suture hemostatic group and the oppression hemostasis group declined significantly after operation (t value was 6.562 and 5.184, both P<0.05).The sinus follicle in suture hemostatic group was significantly more than that in the electric coagulation group ( t =8.749, P <0.01), and AMH and sinus follicle number increased more in the oppression hemostasis group than in the electric coagulation group (t value was 7.194 and 5.837, respectively, both P<0.05).The difference in the incidence of premature ovary failure among three groups was significant (χ2 =9.847, P <0.05).Conclusion Suture hemostasis and oppression hemostasis during laparoscopic ovarian cystectomy are more likely to protect ovarian reserve function , and oppression hemostasis is more effective with caution of cases choosing .