【摘要】：研究背景及目的： 子宮內(nèi)膜異位癥是引起生育期婦女不孕的常見病，發(fā)病率近年來有上升的趨勢(shì)，其具有侵襲性、復(fù)發(fā)性，且病灶分布廣泛，是一類復(fù)雜的臨床疾病。卵巢子宮內(nèi)膜異位囊腫（又稱卵巢巧克力囊腫）是子宮內(nèi)膜異位癥最常見的類型，因多為生育期女性患者，故臨床上多行囊腫剝除術(shù)，保留卵巢。隨著腹腔鏡技術(shù)近年來在婦科手術(shù)中的普及，越來越多有適應(yīng)癥的卵巢囊腫使用此種方法治療。然而，腹腔鏡的操作本身也是一種創(chuàng)傷，術(shù)后卵巢功能衰退也越來越多地被發(fā)現(xiàn)和關(guān)注。本研究的目的是分析腹腔鏡下卵巢巧克力囊腫剝除術(shù)不同止血方式對(duì)卵巢功能的影響。 研究方法： 全面檢索中國(guó)知網(wǎng)、萬(wàn)方中文數(shù)據(jù)庫(kù)、維普數(shù)據(jù)庫(kù)、MEDLINE、PubMed等，檢索工具書、相關(guān)期刊及正在進(jìn)行和未發(fā)表的臨床研究文獻(xiàn)，檢索結(jié)果均至2014年1月，根據(jù)納入排除標(biāo)準(zhǔn)最終入選8篇文獻(xiàn)。根據(jù)Jadad評(píng)分標(biāo)準(zhǔn)，對(duì)收集到所有相關(guān)的隨機(jī)對(duì)照試驗(yàn)(RCTs)進(jìn)行質(zhì)量評(píng)價(jià)。應(yīng)用Cochran系統(tǒng)評(píng)價(jià)軟件Review manager5.2進(jìn)行Meta分析。 結(jié)果: 術(shù)中剝離創(chuàng)面采取縫合止血，，設(shè)為試驗(yàn)組，共253例。術(shù)中剝離創(chuàng)面采取電凝止血(包括單極電凝、雙極電凝)，設(shè)為對(duì)照組，共259例，其中有11例患者術(shù)后失訪。按結(jié)局指標(biāo)進(jìn)行分析，結(jié)果顯示：患者術(shù)后1-2個(gè)月雌二醇(E2)、竇卵泡數(shù)（AFC）均降低，卵泡刺激素(FSH)、黃體生成素(LH)均升高，與術(shù)前比較差異均有統(tǒng)計(jì)學(xué)意義（P㩳0.05），術(shù)后6個(gè)月均恢復(fù)至正常。根據(jù)Meta分析結(jié)果表明，腹腔鏡下卵巢巧克力囊腫剝除術(shù)，無(wú)論縫合止血或是電凝止血都會(huì)使卵巢功能短暫衰退；縫合后的卵巢功能較電凝止血恢復(fù)快。 結(jié)論： 腹腔鏡下卵巢巧克力囊腫剝除術(shù)，無(wú)論縫合止血或是電凝止血都會(huì)使卵巢功能短暫衰退，縫合后的卵巢功能較電凝止血恢復(fù)快。
[Abstract]:Background and objective: endometriosis is a common disease that causes infertility in women in reproductive period. The incidence of endometriosis is increasing in recent years, which is invasive, recurrent and widely distributed. It is a kind of complex clinical disease. Ovarian endometriosis cyst (also called ovarian chocolate cyst) is the most common type of endometriosis. With the popularization of laparoscopic technique in gynecological surgery, more and more ovarian cysts with indications are treated with this method. However, the operation of laparoscopy is also a kind of trauma, postoperative ovarian dysfunction has been more and more noticed and concerned. The purpose of this study was to analyze the effects of different hemostasis methods on ovarian function in laparoscopic ovarian chocolate cyst excision. Reference books, related journals and ongoing and unpublished clinical studies were retrieved until January 2014. Eight articles were selected according to inclusion exclusion criteria. According to Jadad scoring criteria, the quality of (RCTs) collected from all relevant randomized controlled trials was evaluated. Meta analysis was carried out by using Cochran system evaluation software Review manager5.2. Results: the wound was cut off by suture and hemostasis. 253 cases were divided into experimental group (n = 253). Electrocoagulation hemostasis (including unipolar electrocoagulation and bipolar electrocoagulation) was used in the exfoliation of wounds in the operation and was set as control group (259 cases). Among them, 11 cases lost their visit after operation. According to the outcome index, the results showed that estradiol (E _ 2), antral follicle number (AFC) and follicle stimulating hormone (FSH),) luteinizing hormone (LH) increased in 1-2 months after operation. The difference was statistically significant compared with that before operation (P0. 05), and returned to normal 6 months after operation. According to the results of Meta analysis, laparoscopic chocolate cyst excision, either by suture or electrocoagulation, can cause a transient decline in ovarian function, and the ovarian function after suture is faster than that by electrocoagulation. Conclusion: laparoscopic excision of chocolate cyst of ovary, whether suture hemostasis or electrocoagulation hemostasis, will cause the ovarian function to decline temporarily, and the ovarian function after suture is faster than that of electrocoagulation hemostasis.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R713.6

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