3种止血方法对卵巢基质血流及激素水平的影响

Effect of three methods of hemostasis on ovarian stromal blood flow and hormone levels in laparoscopic ovarian tumor stripping

摘要:

目的??比较3种止血法对卵巢基质血流及激素水平的影响。方法?选择2012年5月-2015年10月接受腹腔镜下卵巢肿瘤剥除术的90例患者为研究对象，根据术中创面止血方式不同随机分为3组，A组患者采用单极电凝止血、B组患者采用双极电凝止血、C组患者采用缝合止血，比较3组手术情况、卵巢基质血流和血清性激素水平。结果?A和B组手术时间明显短于C组（t =6.81，7.49，P <0.05）；术后6个月时，B和C组两组卵巢窦状卵泡数（AFC）、基质血流收缩期峰速（PSV）、舒张期最低血流（EDV）均明显高于A组（t =3.79，5.90，3.02，6.82，7.75，3.00，P <0.05），血清黄体生成激素（LH）、促卵泡生成激素（FSH）明显低于A组，雌二醇（E2）明显高于A组（t =10.20，8.49，14.70，11.10，9.21，15.56，P <0.05），且B和C组两组基质血流、血清激素水平比较差异无统计学意义（P >0.05）。结论?腹腔镜卵巢肿瘤剥除术双极电凝止血法有助于减轻手术创伤，维持卵巢基质血流相对稳定，保护卵巢储备功能。

Abstract:

Objective?To study the effect of three methods of hemostasis on ovarian stromal blood flow and hormone levels in laparoscopic ovarian tumor removal. Methods?90 patients received laparoscopic ovarian tumor stripping from May 2012 to October 2015 were randomly divided into three groups according to different operation wound hemostasis. A group patients received unipolar electric coagulation hemostasis, B group patients received bipolar electric coagulation hemostasis, C group patient received suture hemostasis. The operation situation, ovarian stromal blood flow, serum hormone levels were compared between the three groups. Results?Operation time of A group and B group were significantly shorter than C group (t = 6.81, 7.49, P <0.05); 6 months after surgery, B group and C group AFC, PSV, EDV were significantly higher than A group (t = 3.79, 5.90, 3.02, 6.82, 7.75, 3.00, P <0.05), serum LH, FSH were significantly lower than A group , E2 were significantly higher than A group (t = 10.20, 8.49, 14.70, 11.10, 9.21, 15.56, P <0.05), there were no statistical differences of ovarian stromal blood flow, serum hormone levels between B group and C group (P >0.05). Conclusion?Bipolar coagulation hemostasis in laparoscopic ovarian tumor removal helps to reduce the surgical trauma, maintaining ovarian stromal blood flow is relatively stable, and protect the ovarian reserve function.