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目的探讨腹腔镜卵巢瘤剥除术中使用双极电凝、双极电凝+生理盐水冲洗、镜下缝合止血对卵巢功能的影响。方法 94例单侧卵巢良性肿瘤患者,均行腹腔镜卵巢肿瘤剥除术,按不同的止血方法 ,将其分为三组:双极电凝组24例、双极电凝+生理盐水冲洗组36例、镜下缝合组34例。分别于术后3个月比较患者卵泡刺激素(FSH)、窦卵泡计数(AFC)、卵巢体积、卵巢基质血流(PSV)的变化情况。结果术后三组都出现了不同程度的窦卵泡计数、卵巢体积、卵巢基质血流速度下降和FSH增高。但双极电凝+生理盐水冲洗组和镜下缝合组各项指标比较差异无统计学意义(P>0.05)。双极电凝组卵巢储备功能下降明显,与双极电凝+生理盐水冲洗组和镜下缝合组比较差异有统计学意义(P<0.05)。结论腹腔镜下卵巢肿瘤剥除创面采用双极电凝+生理盐水冲洗止血和镜下缝合止血对残留卵巢功能影响小,双极电凝+生理盐水冲洗止血简便易行,是值得提倡的止血方式。
Objective To investigate the effect of bipolar coagulation, bipolar coagulation + saline flushing and microsurgical stitching on ovarian function in laparoscopic ovarian tumor removal. Methods Ninety-four patients with unilateral benign ovarian tumors underwent laparoscopic ovarian tumor resection. According to different methods of hemostasis, they were divided into three groups: Bipolar coagulation group (24 cases), bipolar coagulation + saline group 36 cases, 34 cases of microsurgical suture group. The changes of follicle stimulating hormone (FSH), antral follicle count (AFC), ovarian volume and ovarian stromal blood flow (PSV) in patients at 3 months after operation were compared. Results There were varying degrees of antral follicle count, ovarian volume, ovarian matrix blood flow velocity and FSH increased in all three groups. However, there was no significant difference between Bipolar coagulation + saline flush group and microsurgical suture group (P> 0.05). The ovarian reserve decreased significantly in bipolar coagulation group, which was significantly different from bipolar coagulation + saline flush group and microsurgical suture group (P <0.05). Conclusion laparoscopic ovarian tumor stripping wound using bipolar coagulation + saline flushing and microscopic stitching hemostasis have little effect on residual ovarian function, bipolar coagulation + saline flushing simple and convenient, it is worth promoting the hemostasis .