中国当代医药
中國噹代醫藥
중국당대의약
PERSON
2014年
17期
46-48
,共3页
止血%腹腔镜手术%卵巢子宫内膜异位囊肿%卵巢储备功能
止血%腹腔鏡手術%卵巢子宮內膜異位囊腫%卵巢儲備功能
지혈%복강경수술%란소자궁내막이위낭종%란소저비공능
Hemostasis%Laparoscopic surgery%Ovarian endometriosis cyst%Ovarian reserve function
目的：探讨三种腹腔镜卵巢子宫内膜异位囊肿剥除术中不同止血方法对患者卵巢储备功能的影响。方法选取本院2011年4月~2012年1月收治的122例卵巢子宫内膜异位囊肿患者作为研究对象，常规行腹腔镜卵巢子宫内膜异位囊肿剥除术，按术中不同止血方法分为超声刀组(31例)、双击电凝组(33例)和缝合组(58例)，分别在入院时及术后1、3、6、12个月检测患者FSH及AFC水平，在术后24个月调查患者的自然妊娠情况，比较不同止血方法对三组患者卵巢储备功能的影响。结果入院时三组患者FSH水平比较差异无统计学意义(P>0.05)；术后1、3、6、12个月时三组患者FSH水平较入院时不同程度升高，差异有统计学意义(P<0.05)，且缝合组低于超声刀组和双击电凝组，差异有统计学意义(P<0.05)。入院时及术后1个月三组患者AFC水平比较差异无统计学意义(P>0.05)；在术后3、6、12个月时缝合组患者AFC水平较超声电刀组和双击电凝组高，差异有统计学意义(P<0.05)。术后24个月，缝合组患者的自然妊娠率达36.2%，高于双击电凝组和超声刀组，差异有统计学意义(F=7.285，P<0.05)。结论在卵巢子宫内膜异位囊肿腹腔镜下剥除术中应用超声刀止血法和双击电凝止血法均会降低患者卵巢储备功能，影响患者自然妊娠能力，而缝合法相对影响较小。
目的：探討三種腹腔鏡卵巢子宮內膜異位囊腫剝除術中不同止血方法對患者卵巢儲備功能的影響。方法選取本院2011年4月~2012年1月收治的122例卵巢子宮內膜異位囊腫患者作為研究對象，常規行腹腔鏡卵巢子宮內膜異位囊腫剝除術，按術中不同止血方法分為超聲刀組(31例)、雙擊電凝組(33例)和縫閤組(58例)，分彆在入院時及術後1、3、6、12箇月檢測患者FSH及AFC水平，在術後24箇月調查患者的自然妊娠情況，比較不同止血方法對三組患者卵巢儲備功能的影響。結果入院時三組患者FSH水平比較差異無統計學意義(P>0.05)；術後1、3、6、12箇月時三組患者FSH水平較入院時不同程度升高，差異有統計學意義(P<0.05)，且縫閤組低于超聲刀組和雙擊電凝組，差異有統計學意義(P<0.05)。入院時及術後1箇月三組患者AFC水平比較差異無統計學意義(P>0.05)；在術後3、6、12箇月時縫閤組患者AFC水平較超聲電刀組和雙擊電凝組高，差異有統計學意義(P<0.05)。術後24箇月，縫閤組患者的自然妊娠率達36.2%，高于雙擊電凝組和超聲刀組，差異有統計學意義(F=7.285，P<0.05)。結論在卵巢子宮內膜異位囊腫腹腔鏡下剝除術中應用超聲刀止血法和雙擊電凝止血法均會降低患者卵巢儲備功能，影響患者自然妊娠能力，而縫閤法相對影響較小。
목적：탐토삼충복강경란소자궁내막이위낭종박제술중불동지혈방법대환자란소저비공능적영향。방법선취본원2011년4월~2012년1월수치적122례란소자궁내막이위낭종환자작위연구대상，상규행복강경란소자궁내막이위낭종박제술，안술중불동지혈방법분위초성도조(31례)、쌍격전응조(33례)화봉합조(58례)，분별재입원시급술후1、3、6、12개월검측환자FSH급AFC수평，재술후24개월조사환자적자연임신정황，비교불동지혈방법대삼조환자란소저비공능적영향。결과입원시삼조환자FSH수평비교차이무통계학의의(P>0.05)；술후1、3、6、12개월시삼조환자FSH수평교입원시불동정도승고，차이유통계학의의(P<0.05)，차봉합조저우초성도조화쌍격전응조，차이유통계학의의(P<0.05)。입원시급술후1개월삼조환자AFC수평비교차이무통계학의의(P>0.05)；재술후3、6、12개월시봉합조환자AFC수평교초성전도조화쌍격전응조고，차이유통계학의의(P<0.05)。술후24개월，봉합조환자적자연임신솔체36.2%，고우쌍격전응조화초성도조，차이유통계학의의(F=7.285，P<0.05)。결론재란소자궁내막이위낭종복강경하박제술중응용초성도지혈법화쌍격전응지혈법균회강저환자란소저비공능，영향환자자연임신능력，이봉합법상대영향교소。
Objective To explore the effects of three types of different hemostasis methods in laparoscopic cystectomy for ovarian endometriosis cyst on patients’ ovarian reserve function. Methods 122 patients with ovarian endometriosis cyst in our hospital from April 2011 to January 2012 were selected as research subjects.They received regular laparo-scopic cystectomy for ovarian endometriosis cyst,and were allocated to an ultrasound knife group (31 patients),a bipolar electrocoagulation group (33 patients)and a suture group according to different hemostasis methods during the surgery. FSH and AFC level in patients upon admission,and in 1,3,6 and 12 months after the surgery were tested,and natural pregnancy of patients in 24 months after the surgery was observed.The effects of different hemostasis methods on ovari-an reserve function between the three groups were compared. Results FSH level in the three groups upon admission was compared,with no statistical difference (P>0.05).FSH level in 1,3,6 and 12 months after the surgery in the three groups all increased by difference extent,with statistical difference (P<0.05).The levels in the suture group was signifi-cantly lower than that in the ultrasound knife group and bipolar electrocoagulation group respectively,with statistical difference (P<0.05).AFC level in the three groups upon admission and in 1 month after the surgery was compared re-spectivly,with no statistical difference(P>0.05).AFC level in the suture group in 3,6 and 12 months after the surgery was higher than that in the other two groups respectively,with statistical difference (P<0.05).Natural pregnancy rate in the suture group was 36.2% in 24 months after the surgery,higher than that in the other two groups respectively,with statis-tical difference (F=7.285,P<0.05). Conclusion Hemostasis methods of ultrasound knife and bipolar electrocoagulation which are applied in the laparoscopic cystectomy for ovarian endometriosis cyst both decrease patients’ ovarian reserve function and affect their natural pregnancy.In comparison,the effect of suture is relatively minor.
