腹腔镜下卵巢子宫内膜异位囊肿剥除术后卵巢贮备能力的随机对照研究(1)
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[摘要] 目的：探讨腹腔镜下卵巢子宫内膜异位囊肿剥除术后不同止血方式对卵巢贮备能力的影响。方法：前瞻性纳入2010年1~12月行择期腹腔镜卵巢子宫内膜异位囊肿剥除术患者100例，并随机分为A组(n=50)和B组(n=50)。A组术中予以电凝止血，B组术中予以缝合止血。术后由阴道超声于月经周期第3天盲法采集卵巢窦卵泡计数，采集周期第3天血液测量卵泡刺激素，随访第2、4和6个月经周期，并比较两组间的差异。结果：两组患者基本特征一致。窦卵泡计数明显低于未行手术的正常卵巢组织。A组患者术后各时间点的窦卵泡计数明显低于B组患者，而卵泡刺激素水平明显高于B组，差异均有高度统计学意义(均P<0.001)。结论：卵巢子宫内膜异位囊肿会导致卵巢储备能力下降，囊肿剥除术后行电凝止血的患者卵巢贮备能力低于缝合止血的患者。推荐缝合止血法作为卵巢子宫内膜异位囊肿剥除术后的止血方式。
[关键词] 子宫内膜异位症；卵巢贮备能力；腹腔镜；电凝；缝合
[中图分类号] R711.71 [文献标识码] A [文章编号] 1673-7210(2011)12(b)-067-03
Randomized clinical trial of ovarian reserve capacity after laparoscopic stripping of ovarian endometriomas
YUAN Yuanxia, ZHAO Hongli*, GONG Dian
Department of Gynecology and Obstetrics, Meishan People's Hospital, Sichuan Province, Meishan 620010, China
[Abstract] Objective: To investigate the influence of different hemostasis approaches after laparoscopic stripping for endometriosis on ovarian reserve capacity. Methods: 100 ovarian endometriomas patients treated with elective laparoscopic cystectomy from January to December 2010 were prospectively enrolled, and were randomly divided into two groups with 50 patients in each. Ovarian hemostasis was obtained either by bipolar electrocoagulation in group A, or by suturing in group B. Ovarian antral follicles (AFC) was performed by ultrasound on the third day of the three postoperative menstrual cycles, while follicle stimulating hormone (FSH) was measured in the same day. They were followed up at the 2, 4 and 6 menstrual cycle, and the outcomes were compared between the two groups. Results: The baselines characteristics of two groups were statistically similar. AFC was significantly fewer than that of the normal ovarian tissue. AFC in group A was significantly lower than that in group B at each time point, while FSH level was significantly higher than that in group A, and there were significant differences between the two groups (all P<0.001). Conclusion: Ovarian endometriomas can reduce ovarian reserve. The AFC value suggests that the ovarian reserve is less reduced in sutured ovaries than in those electrocoagulated ......
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