【摘要】：目的 探究腹腔鏡卵巢良性腫瘤切除術(shù)術(shù)中分別采用鏡下縫合止血與電凝止血對患者卵巢功能近期及遠(yuǎn)期的影響，以期在操作過程中減少對卵巢功能的損傷，，進(jìn)而提供有價值的臨床資料。 資料與方法 選取2011年1月至2013年6月泰山醫(yī)學(xué)院附屬醫(yī)院婦產(chǎn)科行腹腔鏡卵巢良性腫瘤切除術(shù)的卵巢良性腫瘤患者63例，分為縫合組（鏡下縫合止血）33例與電凝組（鏡下雙極電凝止血）30例，其中，縫合組包括卵巢漿液性囊腺瘤17例，粘液性囊腺瘤6例，卵巢成熟性畸胎瘤8例，黃體囊腫2例；電凝組包括卵巢漿液性囊腺瘤15例，粘液性囊腺瘤8例，卵巢成熟性畸胎瘤6例，黃體囊腫1例。比較兩組患者術(shù)中的一般情況、術(shù)前和術(shù)后（近期和遠(yuǎn)期）激素水平的變化，并統(tǒng)計分析。 結(jié)果 （1）縫合組比電凝組手術(shù)花費(fèi)時間多、出血多，兩組對照差異有統(tǒng)計學(xué)意義（P0.05）。 （2）兩組均有卵巢早衰現(xiàn)象發(fā)生，其中，縫合組1例，電凝組2例，兩者差異無顯著性（P0.05）。 （3）兩組患者術(shù)后1個月E2下降，而FSH、LH升高，組間及術(shù)前術(shù)后對比有統(tǒng)計學(xué)意義（P0.05）。 （4）術(shù)后3個月兩組患者E2都升高，F(xiàn)SH、LH都降低，組間及術(shù)前術(shù)后對照差異無顯著性（P0.05）。 結(jié)論 （1）內(nèi)鏡縫合組比電凝止血組止血手術(shù)時間長，出血多，可能與內(nèi)鏡縫合手術(shù)操作較電凝止血復(fù)雜有關(guān)，手術(shù)時間長（主要是止血時間長）繼而導(dǎo)致出血多。 （2）內(nèi)鏡縫合止血和雙極電凝止血都對術(shù)后近期的卵巢功能產(chǎn)生一定影響。 （3）卵巢功能手術(shù)3個月后都可以恢復(fù)，兩組比較無明顯差異，提示兩種止血方法對術(shù)后遠(yuǎn)期卵巢功能影響不大。
[Abstract]:Objective to investigate the short-term and long-term effects of endoscopic suture hemostasis and electrocoagulation hemostasis on ovarian function in laparoscopic resection of benign ovarian tumors, so as to reduce the damage to ovarian function in the course of operation. And then provide valuable clinical data. Materials and methods from January 2011 to June 2013, 63 patients with benign ovarian tumors underwent laparoscopic resection of benign ovarian tumors in Department of Gynecology and Obstetrics, affiliated Hospital of Taishan Medical College. They were divided into suture group (33 cases) and electrocoagulation group (30 cases). Among them, there were 17 cases of serous cystadenoma, 6 cases of mucinous cystadenoma and 8 cases of mature teratoma of ovary. Corpus luteum cyst in 2 cases; In the electrocoagulation group, there were 15 cases of serous cystadenoma, 8 cases of mucinous cystadenoma, 6 cases of mature teratoma of ovary and 1 case of corpus cyst. The changes of hormone levels before and after operation (short-term and long-term) were compared between the two groups. Results (1) compared with the electrocoagulation group, the operation time and bleeding in the suture group were more than those in the electrocoagulation group, and there was significant difference between the two groups (P 0.05). (2) premature ovarian failure occurred in both groups, including 1 case in suture group and 2 cases in electrocoagulation group, there was no significant difference between the two groups (P 0.05). (3) E2 decreased and FSH,LH increased 1 month after operation in the two groups, and there was significant difference between the two groups and before and after operation (P 0.05). (4) at 3 months after operation, E2 increased and FSH,LH decreased in both groups, but there was no significant difference between the two groups and before and after operation (P 0.05). Conclusion (1) compared with electrocoagulation group, endoscopic suture group has longer hemostatic operation time and more bleeding, which may be related to the complexity of endoscopic suture operation than electrocoagulation hemostasis, and the long operation time (mainly hemostatic time) leads to more bleeding. (2) endoscopic suture hemostasis and bipolar electrocoagulation hemostasis have some effects on ovarian function in the near future after operation. (3) the ovarian function could be recovered after 3 months of operation, and there was no significant difference between the two groups, suggesting that the two hemostatic methods had little effect on the long-term ovarian function after operation.
【學(xué)位授予單位】：泰山醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R737.31

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