本文關(guān)鍵詞： 卵巢良性囊腫 腹腔鏡手術(shù) 卵巢功能 妊娠 復(fù)發(fā)　出處：《石河子大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討腹腔鏡下卵巢良性囊腫剝除術(shù)在卵巢良性囊腫患者治療中的臨床應(yīng)用價值。方法:收集從2010年1月到2014年12月石河子大學(xué)醫(yī)學(xué)院第一附屬醫(yī)院行腹腔鏡下卵巢良性囊腫剝除術(shù)517例患者的臨床資料,分析不同年齡,不同病理類型及單、雙側(cè)卵巢良性囊腫剝除術(shù)對患者妊娠率、月經(jīng)、腫瘤復(fù)發(fā)率的影響。隨訪≥35歲患者,填寫Kupperman評分表格,統(tǒng)計Kupperman評分。其中卵巢子宮內(nèi)膜異位囊腫共230例,根據(jù)術(shù)后是否注射促性腺激素釋放激素激動劑(GnRH-a)分為兩組,注射組111例,未注射組119例,分析術(shù)后注射促性腺激素釋放激素激動劑(GnRH-a)對患者妊娠率、月經(jīng)、囊腫復(fù)發(fā)率的影響。結(jié)果:患者術(shù)后妊娠率及經(jīng)量減少率在不同的年齡組中均有差異,且差異具有統(tǒng)計學(xué)意義(P0.05)。其中35歲妊娠率為52.14%,≥35歲妊娠率為20.94%,結(jié)果顯示年齡35歲的患者有更高的妊娠率。患者月經(jīng)恢復(fù)的情況顯示年齡35歲月經(jīng)恢復(fù)情況明顯好于年齡≥35歲的患者。通過對患者良性囊腫發(fā)生單、雙側(cè)的研究顯示,單側(cè)卵巢囊腫剔除術(shù)后患者妊娠率高于雙側(cè),且月經(jīng)恢復(fù)好,復(fù)發(fā)率低于雙側(cè),且差異有統(tǒng)計學(xué)意義(P0.05)。通過統(tǒng)計不同病理類型的妊娠率,復(fù)發(fā)率及經(jīng)量減少率,結(jié)果顯示其間的差異具有統(tǒng)計學(xué)意義(P0.05),其中卵巢子宮內(nèi)膜異位囊腫術(shù)后妊娠率較低,復(fù)發(fā)較高,月經(jīng)量較少明顯。通過對不同類型卵巢良性囊腫的Kupperman評分分值進行t檢驗,其中漿液性囊腫56例(19.79%)、粘液性囊腫53例(18.73%)、卵巢子宮內(nèi)膜異位囊腫138例(48.76%)和良性囊性畸胎瘤36例(12.72%)結(jié)果顯示,不同類型良性囊腫之間無顯著性差異(P0.05),表明≥35歲患者術(shù)后生活質(zhì)量變化無明顯不同,卵巢子宮內(nèi)膜異位囊腫剝除術(shù)后注射促性腺激素釋放激素激動劑(Gn RH-a)組與非注射組對患者的術(shù)后妊娠影響有統(tǒng)計學(xué)意義(P0.05),注射促性腺激素釋放激素激動劑(Gn RH-a)的患者術(shù)后妊娠率高于未注射組的患者,而對月經(jīng)及復(fù)發(fā)情況影響無差異性(P0.05),是否注射促性腺激素釋放激素激動劑(Gn RH-a)與月經(jīng)變化及囊腫復(fù)發(fā)無相關(guān)。結(jié)論:1.年齡小于35歲患者術(shù)后的妊娠率及月經(jīng)恢復(fù)情況高于年齡≥35歲的患者。2.單側(cè)卵巢囊腫剔除術(shù)后患者妊娠率高于雙側(cè),且月經(jīng)恢復(fù)好,復(fù)發(fā)率低于雙側(cè)。3.卵巢子宮內(nèi)膜異位囊腫術(shù)后妊娠率較漿液性囊腫,粘液性囊腫及成熟型畸胎瘤妊娠率低,月經(jīng)量較術(shù)前減少。
[Abstract]:Objective: to evaluate the clinical value of laparoscopic excision of benign ovarian cysts in the treatment of benign ovarian cysts. The clinical data of 517 patients with benign ovarian cyst excision under laparoscope were collected from January 2010 to December 2014 in the first affiliated Hospital of Shihezi University Medical College. To analyze the effects of different age, different pathological types and unilateral and bilateral benign ovarian cyst excision on pregnancy rate, menstruation and tumor recurrence rate. To fill out the Kupperman score form and count the Kupperman score, there were 230 cases of ovarian endometriosis cyst. According to whether gonadotropin releasing hormone agonist (GnRH-a) was injected after operation, it was divided into two groups: 111 cases in injection group and 119 cases in non-injection group. To analyze the effect of gonadotropin releasing hormone agonist (GnRH-a) on pregnancy rate and menstruation. Effect of recurrence rate of cysts. Results: the rate of pregnancy and reduction of menstrual volume were different in different age groups. And the difference was statistically significant (P 0.05). The pregnancy rate of 35 years old was 52.14, and that of 鈮，

本文編號：1445169