摘要
目的比较腹腔镜囊肿剥除术与腹腔镜囊肿电凝术治疗卵巢子宫内膜异位囊肿的临床效果。方法选择2015年1月至2016年10月南阳市第一人民医院收治的125例卵巢子宫内膜异位囊肿患者为研究对象,按照手术方式分为观察组(n=65)和对照组(n=60)。观察组患者采用腹腔镜囊肿剥除术,对照组患者采用腹腔镜囊肿电凝术。记录2组患者的手术时间和术中出血量;术后1个月,采用视觉模拟评分法(VAS)对2组患者疼痛进行评分;分别于术前及术后1、6个月,采用化学发光法检测患者血清卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_2)及黄体酮(P)水平,采用经阴道多普勒超声检测卵巢基质动脉血流收缩期峰值(PSV)和卵巢窦状卵泡数目(AFC);观察2组患者术后6个月内囊肿复发情况。结果 2组患者的手术时间、术中出血量、术后VAS评分比较差异均无统计学意义(P> 0. 05)。术前2组患者血清FSH、LH、E_2及P水平比较差异均无统计学意义(P> 0. 05)。2组患者术后1个月时血清FSH、LH水平显著高于术前,E_2、P水平显著低于术前(P <0. 05)。对照组患者术后6个月时血清FSH、LH水平显著低于术后1个月(P <0. 05),对照组患者术后6个月与术后1个月时血清E_2、P水平比较差异无统计学意义(P>0. 05)。观察组患者术后6个月时血清FSH、LH水平显著低于术后1个月,E_2水平显著高于术后1个月(P <0. 05);观察组患者术后6个月与术后1个月时血清P水平比较差异无统计学意义(P> 0. 05)。术后1、6个月,观察组患者血清FSH、LH水平显著低于对照组,E_2、P水平显著高于对照组(P <0. 05)。术前2组患者卵巢基质动脉PSV、AFC比较差异均无统计学意义(P> 0. 05); 2组患者术后1个月时卵巢基质动脉PSV、AFC显著低于术前(P <0. 05),2组患者术后6个月时卵巢基质动脉PSV、AFC显著高于术后1个月(P <0. 05);术后6个月,观察组患者卵巢基质动脉PSV、AFC显著高于对照组(P <0. 05)。术后6个月内,观察组和对照组患者囊肿复发率分别为6. 15%(4/65)和18. 33%(11/60),观察组患者囊肿复发率低于对照组(χ~2=4. 383,P <0. 05)。结论与腹腔镜囊肿电凝术比较,腹腔镜囊肿剥除术对卵巢子宫内膜异位囊肿患者的卵巢功能损害较小,且囊肿复发率低。
Objective To compare the clinical effect of laparoscopic oophorocystectomy and laparoscopic electrocoagulation in the treatment of ovarian endometriosis cyst. Methods A total of 125 patients with ovarian endometriosis cyst in the First People’s Hospital of Nanyang City from January 2015 to October 2016 were selected as the study subjects,and the patients were divided into observation group( n = 65) and control group( n = 60) according to the operation method. The patients in the observation group were treated with laparoscopic oophorocystectomy,while the patients in the control group were treated with laparoscopic electrocoagulation. The operation time and intraoperative bleeding volume were recorded in the two groups. The pain of the patients in two groups was evaluated by visual analogue scale( VAS) at one month after operation. The levels of serum follicle stimulating hormone( FSH),luteinizing hormone( LH),estradiol( E2) and progesterone( P) were measured by chemiluminescence method before operation and 1,6 months after operation. The peak systolic velocity( PSV) of ovarian stromal artery and the number of ovarian antral follicle count( AFC) were measured by transvaginal Doppler ultrasound. The recurrence of cysts in the two groups was observed within 6 months after operation. Results There was no significant difference in the operation time,intraoperative bleeding volume and VAS score between the two groups( P > 0. 05).There was no significant difference in the levels of serum FSH,LH,E2 and P between the two groups before operation( P >0. 05). The levels of serum FSH and LH at one month after operation were significantly higher than those before operation,and the levels of serum E2 and P at one month after operation were significantly lower than those before operation in the two groups( P < 0. 05). The levels of serum FSH and LH at six months after operation were significantly lower than those at one month after operation in the control group( P < 0. 05). There was no significant difference in the levels of serum E2 and P between six months after operation and one month after operation in the control group( P > 0. 05). The levels of serum FSH and LH at six months after operation were significantly lower than that at one month after operation in the observation group( P < 0. 05). The level of serum E2 at six months after operation was significantly higher than that at one month after operation in the observation group( P < 0. 05). There was no significant difference in the level of serum P between six months and one month after operation in the observation group( P > 0. 05). The levels of serum FSH and LH in the observation group were significantly lower than those in the control group at one and six months after operation( P < 0. 05). The levels of serum E2 and P in the observation group were significantly higher than those in the control group at one and six months after operation( P < 0. 05).There was no significant difference in PSV of ovarian stromal artery and AFC between the two groups before operation( P >0. 05). The PSV of ovarian stromal artery and AFC of were significantly lower at one month after operation than those before operation in the two groups( P < 0. 05). The PSV of ovarian stromal artery and AFC at six months after operation were significantly higher than those at one month after operation in the two groups( P < 0. 05). The PSV of ovarian stromal artery and AFC in the observation group were significantly higher than those in the control group at six months after operation( P <0. 05). Within six months after operation,the recurrence rate of cysts in the observation group and the control group was6. 15%( 4/65) and 18. 33%( 11/60),respectively. The recurrence rate of cysts in the observation group were lower than that in the control group( χ2= 4. 383,P < 0. 05). Conclusion Compared with laparoscopic cyst electrocoagulation,laparoscopic oophorocystectomy has less damage to ovarian function and lower recurrence rate of ovarian endometriosis cyst.
作者
王珂
李宛玲
姜克萍
WANG Ke;LI Wan-ling;JIANG Ke-ping(Department of Gynaecology and Obstetrics,the First People's Hospital of Nanyang City,Nanyang 473000,Henan Province,China)
出处
《新乡医学院学报》
CAS
2019年第3期271-274,共4页
Journal of Xinxiang Medical University
