腹腔镜下卵巢良性肿瘤切除术术中止血方式对卵巢功能的影响

发布时间：2019-05-14 18:49

【摘要】：目的探究腹腔镜卵巢良性肿瘤切除术术中分别采用镜下缝合止血与电凝止血对患者卵巢功能近期及远期的影响，以期在操作过程中减少对卵巢功能的损伤，，进而提供有价值的临床资料。资料与方法选取2011年1月至2013年6月泰山医学院附属医院妇产科行腹腔镜卵巢良性肿瘤切除术的卵巢良性肿瘤患者63例，分为缝合组（镜下缝合止血）33例与电凝组（镜下双极电凝止血）30例，其中，缝合组包括卵巢浆液性囊腺瘤17例，粘液性囊腺瘤6例，卵巢成熟性畸胎瘤8例，黄体囊肿2例；电凝组包括卵巢浆液性囊腺瘤15例，粘液性囊腺瘤8例，卵巢成熟性畸胎瘤6例，黄体囊肿1例。比较两组患者术中的一般情况、术前和术后（近期和远期）激素水平的变化，并统计分析。结果（1）缝合组比电凝组手术花费时间多、出血多，两组对照差异有统计学意义（P0.05）。（2）两组均有卵巢早衰现象发生，其中，缝合组1例，电凝组2例，两者差异无显著性（P0.05）。（3）两组患者术后1个月E2下降，而FSH、LH升高，组间及术前术后对比有统计学意义（P0.05）。（4）术后3个月两组患者E2都升高，FSH、LH都降低，组间及术前术后对照差异无显著性（P0.05）。结论（1）内镜缝合组比电凝止血组止血手术时间长，出血多，可能与内镜缝合手术操作较电凝止血复杂有关，手术时间长（主要是止血时间长）继而导致出血多。（2）内镜缝合止血和双极电凝止血都对术后近期的卵巢功能产生一定影响。（3）卵巢功能手术3个月后都可以恢复，两组比较无明显差异，提示两种止血方法对术后远期卵巢功能影响不大。
[Abstract]:Objective to investigate the short-term and long-term effects of endoscopic suture hemostasis and electrocoagulation hemostasis on ovarian function in laparoscopic resection of benign ovarian tumors, so as to reduce the damage to ovarian function in the course of operation. And then provide valuable clinical data. Materials and methods from January 2011 to June 2013, 63 patients with benign ovarian tumors underwent laparoscopic resection of benign ovarian tumors in Department of Gynecology and Obstetrics, affiliated Hospital of Taishan Medical College. They were divided into suture group (33 cases) and electrocoagulation group (30 cases). Among them, there were 17 cases of serous cystadenoma, 6 cases of mucinous cystadenoma and 8 cases of mature teratoma of ovary. Corpus luteum cyst in 2 cases; In the electrocoagulation group, there were 15 cases of serous cystadenoma, 8 cases of mucinous cystadenoma, 6 cases of mature teratoma of ovary and 1 case of corpus cyst. The changes of hormone levels before and after operation (short-term and long-term) were compared between the two groups. Results (1) compared with the electrocoagulation group, the operation time and bleeding in the suture group were more than those in the electrocoagulation group, and there was significant difference between the two groups (P 0.05). (2) premature ovarian failure occurred in both groups, including 1 case in suture group and 2 cases in electrocoagulation group, there was no significant difference between the two groups (P 0.05). (3) E2 decreased and FSH,LH increased 1 month after operation in the two groups, and there was significant difference between the two groups and before and after operation (P 0.05). (4) at 3 months after operation, E2 increased and FSH,LH decreased in both groups, but there was no significant difference between the two groups and before and after operation (P 0.05). Conclusion (1) compared with electrocoagulation group, endoscopic suture group has longer hemostatic operation time and more bleeding, which may be related to the complexity of endoscopic suture operation than electrocoagulation hemostasis, and the long operation time (mainly hemostatic time) leads to more bleeding. (2) endoscopic suture hemostasis and bipolar electrocoagulation hemostasis have some effects on ovarian function in the near future after operation. (3) the ovarian function could be recovered after 3 months of operation, and there was no significant difference between the two groups, suggesting that the two hemostatic methods had little effect on the long-term ovarian function after operation.
【学位授予单位】：泰山医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.31

【参考文献】