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目的:分析腹腔镜卵巢囊肿剥除术后不同止血方式对卵巢功能的影响。方法:选取2010年1月至2015年6月于该院行腹腔镜卵巢囊肿剥除术的患者142例作为研究对象,按手术止血方法的不同分为超声刀组(31例)、单极电凝组(38例)、双极电凝组(41例)以及镜下缝合组(32例)。术后对所有患者进行为期1年的随访,于术前和术后1个月、3个月、12个月时血清中FSH、LH及E_2的含量。结果:术后1个月时,各组患者的血清中E_2水平均较手术前明显下降(P<0.05),FSH与LH则较术前明显升高(P<0.05),以单极电凝组患者E_2下降和FSH、LH升高最为明显(P<0.05);术后3个月时,超声刀组和镜下缝合组的血清E_2含量基本恢复至术前水平,单极电凝组、双极电凝组E_2含量低于术前(P<0.05),各组患者血清FSH和LH仍高于术前(P<0.05);术后12个月时,单极电凝组和双极电凝组的血清E_2含量仍低于术前(P<0.05),FSH和LH高于术前(P<0.05)。结论:腹腔镜卵巢囊肿剥除术后采用不同的止血方式对卵巢功能影响存在显著性差异,应尽量避免使用电凝止血方式,而使用超声刀或镜下缝合方式进行止血。
Objective: To analyze the effect of different ways of hemostasis after ovariectomy on ovarian function in patients with laparoscopic ovarian cysts. Methods: From January 2010 to June 2015, 142 patients with laparoscopic ovarian cyst excision in our hospital were selected as the study objects. According to the method of surgical hemostasis, they were divided into three groups: ultrasound knife group (31 cases), unipolar Coagulation group (38 cases), bipolar coagulation group (41 cases) and microsurgical suture group (32 cases). All patients were followed up for one year. The levels of serum FSH, LH and E_2 in preoperative and postoperative 1 month, 3 months and 12 months were determined. Results: At 1 month after operation, the levels of E 2 in serum of patients in each group were significantly lower than those before operation (P <0.05), but FSH and LH were significantly higher than those before operation (P <0.05) E 2 decreased and FSH increased significantly (P <0.05). After 3 months, the content of E 2 in the ultrasonic knife group and the microsurgical suture group basically recovered to the preoperative level. In the unipolar coagulation group, The content of E_2 in bipolar coagulation group was lower than that before operation (P <0.05), and the levels of serum FSH and LH in each group were still higher than those before operation (P <0.05). At 12 months after operation, monopolar coagulation group and bipolar The content of E_2 in the electrocoagulation group was still lower than that before operation (P <0.05), and the levels of FSH and LH were higher than those before operation (P <0.05). Conclusion: There are significant differences in the ovarian function between laparoscopic ovarian cyst and different hemostatic methods. The method of electrocoagulation and hemostasis should be avoided as far as possible, and the use of ultrasound knife or endoscopic suture to stop bleeding.