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目的:探讨在腹腔镜卵巢囊肿剔除术中两种不同的止血方法对术后卵巢功能的影响。方法:选取卵巢良性囊性病变患者312例,其中卵巢畸胎瘤112例,卵巢巧克力囊肿158例,卵巢囊腺瘤42例。将其均分为两组,各用一种方法止血。患者分别于术前、术后6个月抽血检测血清中抑制素B(INHB)、雌二醇(E2)、孕激素(P)水平,并采用术后B超监测卵巢体积、卵巢间质血流指数等。结果:①缝合止血组术前与术后血清INHB、E2、P水平比较差异无统计学意义(P>0.05)。②不缝合止血组术前与术后血清INHB、E2、P水平比较差异无统计学意义(P>0.05)。③缝合组与不缝合组术前激素水平比较差异无统计学意义(P>0.05);缝合组与不缝合组术后激素水平比较差异无统计学意义(P>0.05)。④术后超声监测显示卵巢大小均在正常范围内,均无卵巢囊肿复发者;不缝合组卵巢间质血流峰值流速>缝合组,差异均有统计学意义(P<0.05)。结论:腹腔镜卵巢囊肿剔除术中两种止血方法均不影响卵巢甾体激素生成功能,故对良性卵巢囊肿患者行腹腔镜卵巢囊肿剔除术可最大限度地保留其卵巢功能。对于育龄期患者使用双极局部电凝创面,剩余卵巢组织不缝合止血法可较好地保留卵巢反应性。
Objective: To investigate the effects of two different hemostatic methods on postoperative ovarian function in laparoscopic ovarian cyst excision. Methods: 312 cases of benign ovarian cystic lesions were selected, including 112 cases of ovarian teratoma, 158 cases of ovarian chocolate cyst and 42 cases of ovarian cystadenoma. Will be equally divided into two groups, each with a method to stop bleeding. The levels of inhibin B (INHB), estradiol (E2) and progesterone (P) in serum were measured before and 6 months after operation. The ovarian volume, Blood flow index and so on. Results: ① There was no significant difference in serum INHB, E2, P levels between preoperative and postoperative suture hemostatic groups (P> 0.05). ② There was no significant difference in serum levels of INHB, E2 and P between preoperative and postoperative patients without suture hemostasis (P> 0.05). There was no significant difference in preoperative hormone levels between suture group and non-suture group (P> 0.05). There was no significant difference in hormone levels between suture group and non-suture group (P> 0.05). ④ postoperative ultrasound monitoring showed that the size of ovaries were within the normal range, no recurrence of ovarian cysts; not suture group ovarian stromal flow peak velocity> suture group, the difference was statistically significant (P <0.05). Conclusions: The two methods of hemostasis during laparoscopic ovarian cyst excision do not affect the ovarian steroidogenic function. Therefore, laparoscopic ovarian cyst excision in patients with benign ovarian cyst can preserve ovarian function to the maximum. For childbearing age patients with bipolar local electrocoagulation wound, the remaining ovarian tissue is not stitched hemostasis can better retain ovarian response.