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目的观察腹腔镜下输卵管切除术、卵巢囊肿剥除术、卵巢子宫内膜异位囊肿剥除术对卵巢储备功能的影响。方法选择在医院行腹腔镜手术142例,其中输卵管切除术的患者50例为A组,腹腔镜下卵巢囊肿剥除术后病理为良性肿瘤除外子宫内膜异位症手术的患者47例为B组,卵巢子宫内膜异位囊肿剥除术45例为C组。检测患者手术前,术后1个月、术后6个月测促卵泡激素(FSH)、抗苗勒管激素(AMH)及窦状卵泡计数(AFC)等指标的变化。结果手术后1个月A组血清AMH、AFC数值均略低于手术前,FSH水平略高于手术前,但差异无统计学意义(P>0.05)。B、C组血清AMH水平、AFC数值均低于手术前,血清FSH水平高于手术前,差异均有统计学意义(P<0.05)。手术后6个月A、B组血清AMH、AFC数值均略低于手术前,FSH水平略高于手术前,差异无统计学意义(P>0.05)。C组血清FSH水平略高于手术前,差异无统计学意义(P>0.05)。C组血清AMH水平、AFC数值低于手术前,差异有统计学意义(P<0.05)。结论腹腔镜输卵管切除术对卵巢储备功能无影响,卵巢囊肿剥除术后短时间内会对卵巢功能产生影响,但经一定时间的恢复后,患者卵巢功能有所恢复,卵巢子宫内膜异位囊肿对卵巢功储备能有损伤。血清AMH在评估腹腔镜下卵巢有创术后卵巢储备功能方面优于血清指标FSH及超声指标AFC。
Objective To observe the effects of laparoscopic tubal resection, ovarian cyst excision and ovarian endometriosis cyst on ovarian reserve function. Methods Select 142 cases of laparoscopic surgery in the hospital, 50 cases of tubal resection in the group A, laparoscopic removal of ovarian cyst after removal of benign lesions in patients with endometriosis in 47 cases of patients with B Group, 45 cases of ovarian endometriosis cyst stripping group C. The changes of FSH, AMH and AFC were measured before operation, 1 month after operation and 6 months after operation. Results The serum AMH and AFC values of group A were slightly lower than those before operation and the FSH level was slightly higher than that before operation at 1 month after operation, but the difference was not statistically significant (P> 0.05). The levels of AMH and AFC in group B and group C were lower than those before operation, and the level of serum FSH was higher than that before operation (P <0.05). At 6 months after operation, the serum levels of AMH and AFC in group A and B were slightly lower than those before operation, and the level of FSH was slightly higher than that before operation (P> 0.05). Serum FSH level in group C was slightly higher than that before operation, the difference was not statistically significant (P> 0.05). The level of serum AMH and the value of AFC in group C were lower than those before operation, the difference was statistically significant (P <0.05). Conclusions Laparoscopic tubal resection has no effect on ovarian reserve function. Ovarian function can be affected in a short time after ovarian cyst excision. However, after a certain period of recovery, the ovarian function of the patient has been restored. The ovarian endometriosis Cysts on ovarian reserve can be damaged. Serum AMH is superior to serum FSH and AFC in assessing ovarian invasive ovarian reserve after laparoscopic surgery.