腹腔镜下卵巢巧克力囊肿剥除术止血方式对卵巢功能影响的Meta分析

发布时间：2018-11-13 09:23

【摘要】：研究背景及目的：子宫内膜异位症是引起生育期妇女不孕的常见病，发病率近年来有上升的趋势，其具有侵袭性、复发性，且病灶分布广泛，是一类复杂的临床疾病。卵巢子宫内膜异位囊肿（又称卵巢巧克力囊肿）是子宫内膜异位症最常见的类型，因多为生育期女性患者，故临床上多行囊肿剥除术，保留卵巢。随着腹腔镜技术近年来在妇科手术中的普及，越来越多有适应症的卵巢囊肿使用此种方法治疗。然而，腹腔镜的操作本身也是一种创伤，术后卵巢功能衰退也越来越多地被发现和关注。本研究的目的是分析腹腔镜下卵巢巧克力囊肿剥除术不同止血方式对卵巢功能的影响。研究方法：全面检索中国知网、万方中文数据库、维普数据库、MEDLINE、PubMed等，检索工具书、相关期刊及正在进行和未发表的临床研究文献，检索结果均至2014年1月，根据纳入排除标准最终入选8篇文献。根据Jadad评分标准，对收集到所有相关的随机对照试验(RCTs)进行质量评价。应用Cochran系统评价软件Review manager5.2进行Meta分析。结果: 术中剥离创面采取缝合止血，，设为试验组，共253例。术中剥离创面采取电凝止血(包括单极电凝、双极电凝)，设为对照组，共259例，其中有11例患者术后失访。按结局指标进行分析，结果显示：患者术后1-2个月雌二醇(E2)、窦卵泡数（AFC）均降低，卵泡刺激素(FSH)、黄体生成素(LH)均升高，与术前比较差异均有统计学意义（P㩳0.05），术后6个月均恢复至正常。根据Meta分析结果表明，腹腔镜下卵巢巧克力囊肿剥除术，无论缝合止血或是电凝止血都会使卵巢功能短暂衰退；缝合后的卵巢功能较电凝止血恢复快。结论：腹腔镜下卵巢巧克力囊肿剥除术，无论缝合止血或是电凝止血都会使卵巢功能短暂衰退，缝合后的卵巢功能较电凝止血恢复快。
[Abstract]:Background and objective: endometriosis is a common disease that causes infertility in women in reproductive period. The incidence of endometriosis is increasing in recent years, which is invasive, recurrent and widely distributed. It is a kind of complex clinical disease. Ovarian endometriosis cyst (also called ovarian chocolate cyst) is the most common type of endometriosis. With the popularization of laparoscopic technique in gynecological surgery, more and more ovarian cysts with indications are treated with this method. However, the operation of laparoscopy is also a kind of trauma, postoperative ovarian dysfunction has been more and more noticed and concerned. The purpose of this study was to analyze the effects of different hemostasis methods on ovarian function in laparoscopic ovarian chocolate cyst excision. Reference books, related journals and ongoing and unpublished clinical studies were retrieved until January 2014. Eight articles were selected according to inclusion exclusion criteria. According to Jadad scoring criteria, the quality of (RCTs) collected from all relevant randomized controlled trials was evaluated. Meta analysis was carried out by using Cochran system evaluation software Review manager5.2. Results: the wound was cut off by suture and hemostasis. 253 cases were divided into experimental group (n = 253). Electrocoagulation hemostasis (including unipolar electrocoagulation and bipolar electrocoagulation) was used in the exfoliation of wounds in the operation and was set as control group (259 cases). Among them, 11 cases lost their visit after operation. According to the outcome index, the results showed that estradiol (E _ 2), antral follicle number (AFC) and follicle stimulating hormone (FSH),) luteinizing hormone (LH) increased in 1-2 months after operation. The difference was statistically significant compared with that before operation (P0. 05), and returned to normal 6 months after operation. According to the results of Meta analysis, laparoscopic chocolate cyst excision, either by suture or electrocoagulation, can cause a transient decline in ovarian function, and the ovarian function after suture is faster than that by electrocoagulation. Conclusion: laparoscopic excision of chocolate cyst of ovary, whether suture hemostasis or electrocoagulation hemostasis, will cause the ovarian function to decline temporarily, and the ovarian function after suture is faster than that of electrocoagulation hemostasis.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R713.6

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