【摘要】：目的探討腹腔鏡下卵巢巧克力囊腫剔除術(shù)中電凝、縫合和壓迫3種不同止血方式對術(shù)后卵巢功能的影響,為臨床決策提供依據(jù)。方法將120例卵巢巧克力囊腫患者隨機(jī)分為電凝組、縫合組和壓迫組,在腹腔鏡下卵巢巧克力囊腫剔除術(shù)中分別行電凝、縫合和壓迫止血。所有患者術(shù)前及術(shù)后1、6個(gè)月于月經(jīng)期第2~3天空腹抽取肘靜脈血,測定血清卵泡刺激素(FSH)、黃體生成素(LH)和雌二醇(E2);采血當(dāng)天采用陰道多普勒超聲檢測雙側(cè)卵巢動脈血流的收縮期峰值(PSV)并測定竇狀卵泡數(shù)目(F0)。結(jié)果電凝組術(shù)后1、6個(gè)月時(shí)的血清E2、PSV、F0低于術(shù)前(P均0.05),血清FSH高于術(shù)前(P0.05);縫合組術(shù)后1、6個(gè)月時(shí)的PSV、F0低于術(shù)前(P均0.05),術(shù)后6個(gè)月時(shí)的FSH高于術(shù)前(P0.05);壓迫組術(shù)后1、6個(gè)月時(shí)的PSV、F0低于術(shù)前(P均0.05)�？p合組、壓迫組術(shù)后1個(gè)月時(shí)的PSV及術(shù)后6個(gè)月時(shí)的FSH、E2、PSV、F0與電凝組相比,P均0.05;壓迫組術(shù)后1個(gè)月時(shí)的PSV及術(shù)后6個(gè)月時(shí)的E2與縫合組相比,P均0.05。結(jié)論腹腔鏡下卵巢巧克力囊腫剔除術(shù)患者卵巢儲備功能下降;血清基礎(chǔ)FSH、LH、E2、竇卵泡數(shù)及卵巢基質(zhì)血管收縮期PSV能較好反映卵巢的儲備功能;與電凝止血法相比,術(shù)中縫合止血法和壓迫止血法可更好地保護(hù)卵巢功能。
[Abstract]:Objective to investigate the effects of three different hemostatic methods, such as electrocoagulation, suture and compression, on ovarian function during laparoscopic ovarian chocolate cyst removal, and to provide evidence for clinical decision making. Methods 120 patients with ovarian chocolate cyst were randomly divided into three groups: electrocoagulation group, suture group and compression group. The venous blood samples were taken from all patients before and 1, 6 months after menstruation on the 2nd day of menstrual period. Serum follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E _ 2) were measured. The systolic peak (PSV) of bilateral ovarian artery blood flow and the number of antral follicles (F0) were measured by vagina Doppler ultrasound on the day of blood collection. Results at 1 and 6 months after operation, the serum E2P PSV F0 was lower and the serum FSH was higher in the electrocoagulation group than before (P0.05). The PSV,F0 of the suture group was lower at 1 and 6 months after operation than that before operation (P 0.05), and the FSH at 6 months after operation was higher than that before operation (P0.05), and the PSV,F0 of compression group at 1 and 6 months after operation was lower than that before operation (P 0.05). In the suture group, the PSV at 1 month after operation and the FSH,E2,PSV,F0 at 6 months after operation in the compression group were significantly higher than those in the electrocoagulation group (P 0.05), while the PSV in the compression group at 1 month after operation and E2 at 6 months after operation were significantly higher than those in the suture group (P 0.05). Conclusion the ovarian reserve function of patients undergoing ovarian chocolate cyst removal under laparoscope is decreased, the number of basic FSH,LH,E2, antral follicles in serum and PSV in ovarian stromal vasoconstriction can better reflect the reserve function of ovary. Compared with electrocoagulation hemostasis, suture hemostasis and compression hemostasis can better protect ovarian function.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R713.6

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1 楊冰;何麗霞;佘遠(yuǎn)萍;陳輝;;腹腔鏡卵巢內(nèi)異癥囊腫剝除術(shù)囊內(nèi)多點(diǎn)縫合止血法的應(yīng)用價(jià)值[J];華夏醫(yī)學(xué);2013年03期

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