517例腹腔镜下卵巢良性囊肿剥除术后患者随访资料分析

发布时间：2018-01-19 19:01

  本文关键词： 卵巢良性囊肿 腹腔镜手术 卵巢功能 妊娠 复发　出处：《石河子大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨腹腔镜下卵巢良性囊肿剥除术在卵巢良性囊肿患者治疗中的临床应用价值。方法:收集从2010年1月到2014年12月石河子大学医学院第一附属医院行腹腔镜下卵巢良性囊肿剥除术517例患者的临床资料,分析不同年龄,不同病理类型及单、双侧卵巢良性囊肿剥除术对患者妊娠率、月经、肿瘤复发率的影响。随访≥35岁患者,填写Kupperman评分表格,统计Kupperman评分。其中卵巢子宫内膜异位囊肿共230例,根据术后是否注射促性腺激素释放激素激动剂(GnRH-a)分为两组,注射组111例,未注射组119例,分析术后注射促性腺激素释放激素激动剂(GnRH-a)对患者妊娠率、月经、囊肿复发率的影响。结果:患者术后妊娠率及经量减少率在不同的年龄组中均有差异,且差异具有统计学意义(P0.05)。其中35岁妊娠率为52.14%,≥35岁妊娠率为20.94%,结果显示年龄35岁的患者有更高的妊娠率。患者月经恢复的情况显示年龄35岁月经恢复情况明显好于年龄≥35岁的患者。通过对患者良性囊肿发生单、双侧的研究显示,单侧卵巢囊肿剔除术后患者妊娠率高于双侧,且月经恢复好,复发率低于双侧,且差异有统计学意义(P0.05)。通过统计不同病理类型的妊娠率,复发率及经量减少率,结果显示其间的差异具有统计学意义(P0.05),其中卵巢子宫内膜异位囊肿术后妊娠率较低,复发较高,月经量较少明显。通过对不同类型卵巢良性囊肿的Kupperman评分分值进行t检验,其中浆液性囊肿56例(19.79%)、粘液性囊肿53例(18.73%)、卵巢子宫内膜异位囊肿138例(48.76%)和良性囊性畸胎瘤36例(12.72%)结果显示,不同类型良性囊肿之间无显著性差异(P0.05),表明≥35岁患者术后生活质量变化无明显不同,卵巢子宫内膜异位囊肿剥除术后注射促性腺激素释放激素激动剂(Gn RH-a)组与非注射组对患者的术后妊娠影响有统计学意义(P0.05),注射促性腺激素释放激素激动剂(Gn RH-a)的患者术后妊娠率高于未注射组的患者,而对月经及复发情况影响无差异性(P0.05),是否注射促性腺激素释放激素激动剂(Gn RH-a)与月经变化及囊肿复发无相关。结论:1.年龄小于35岁患者术后的妊娠率及月经恢复情况高于年龄≥35岁的患者。2.单侧卵巢囊肿剔除术后患者妊娠率高于双侧,且月经恢复好,复发率低于双侧。3.卵巢子宫内膜异位囊肿术后妊娠率较浆液性囊肿,粘液性囊肿及成熟型畸胎瘤妊娠率低,月经量较术前减少。
[Abstract]:Objective: to evaluate the clinical value of laparoscopic excision of benign ovarian cysts in the treatment of benign ovarian cysts. The clinical data of 517 patients with benign ovarian cyst excision under laparoscope were collected from January 2010 to December 2014 in the first affiliated Hospital of Shihezi University Medical College. To analyze the effects of different age, different pathological types and unilateral and bilateral benign ovarian cyst excision on pregnancy rate, menstruation and tumor recurrence rate. To fill out the Kupperman score form and count the Kupperman score, there were 230 cases of ovarian endometriosis cyst. According to whether gonadotropin releasing hormone agonist (GnRH-a) was injected after operation, it was divided into two groups: 111 cases in injection group and 119 cases in non-injection group. To analyze the effect of gonadotropin releasing hormone agonist (GnRH-a) on pregnancy rate and menstruation. Effect of recurrence rate of cysts. Results: the rate of pregnancy and reduction of menstrual volume were different in different age groups. And the difference was statistically significant (P 0.05). The pregnancy rate of 35 years old was 52.14, and that of 鈮，

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