摘要
目的:观察卵巢囊肿患者实施腹腔镜微创手术的效果,并探讨对其卵巢功能的影响。方法:将69例卵巢囊肿患者的临床资料进行总结和回顾,其中32例实施开放性手术记为开放组,37例实施腹腔镜微创手术记为微创组。对比两组手术指标,术前、术后3个月两组窦状卵泡数、促卵泡生成激素(FSH)、促黄体生成素(LH)变化,随访3个月并发症发生率。结果:微创组出血量少于开放组(P<0.05),手术耗时、术后首次排气及持续住院时间均短于开放组(P<0.05);微创组术前和术后3个月窦状卵泡数、FSH和LH均无变化(P>0.05),开放组术后3个月窦状卵泡数少于术前(P<0.05),FSH和LH水平均高于术前(P<0.05),且术后3个月两组卵巢功能指标对比差异均有统计学意义(P<0.05);微创组随访3个月内并发症发生率低于开放组(P<0.05)。结论:卵巢囊肿患者实施腹腔镜微创手术创伤小,恢复快,对卵巢功能不会造成明显的伤害,且术后并发症少。
Objective:To observe the effect of laparoscopic minimally invasive surgery on ovarian cysts and its effect on ovarian function.Method:The clinical data of 69 cases of ovarian cysts surgery were summarized and reviewed.Among them,32 cases underwent open surgery(the open group)and 37 cases underwent laparoscopic minimally invasive surgery(the minimally invasive group).The number of sinusoidal follicles,follicle stimulating hormone(FSH)and luteinizing hormone(LH)were compared between two groups before and 3 months after operation.The total complication rate was followed up for 3 months.Results:The amount of bleeding in the minimally invasive group was less than that in the open group(P<0.05).The operative time,postoperative first exhaust and continuous hospitalization time of the minimally invasive group were shorter than those of the open group(P<0.05).In the minimally invasive group,there were no change in the number of antral follicles,FSH and LH before and 3 months after operation(P>0.05).The number of antral follicles in the open group 3 months after operation was lower than that of before operation(P<0.05),the levels of FSH and LH were higher than those of before operation(P<0.05).There were statistically significant differences in ovarian function between two groups at 3 months after operation(P<0.05).The incidence of complications in the minimally invasive group was lower than that in the open group(P<0.05)during 3 months follow-up.Conclusion:Laparoscopic minimally invasive surgery for ovarian cysts has on advantages of less trauma,quick recovery,no obvious damage to ovarian function,and less postoperative complications.
引文
[1]陶云燕,朱琳,彭顺秀.腹腔镜微创手术治疗良性卵巢囊肿过程中应用手术室护理干预的效果分析[J].中国医学创新,2018,15(12):92-95.
[2]周智.腹腔镜卵巢囊肿剔除术治疗卵巢囊肿的效果及其对卵巢功能影响的研究[J].中国临床医生杂志,2018,46(2):216-218.
[3]栾梅,孟聪然.经阴道穿刺手术治疗卵巢囊肿及对其卵巢功能的影响[J].实用临床医药杂志,2016,20(1):102-104.
[4]白海燕.经腹腔镜下卵巢囊肿剥除术与经腹卵巢囊肿剥除术对卵巢囊肿患者术后卵巢储备功能的影响[J].实用癌症杂志,2017,32(11):1879-1881.
[5]黄荷凤.妇产科常见疾病诊治指南[M].杭州:浙江大学出版社,2010:8.
[6]解晓红.腹腔镜微创手术治疗卵巢肿瘤的临床疗效及对卵巢功能的影响[J].中国妇幼保健,2018,33(15):3559-3561.
[7]韩娟,张萌萌.腹腔镜微创手术对卵巢良性肿瘤的卵巢功能与免疫功能的保护作用[J].医学综述,2017,23(1):201-204.
[8]庄玉青.腹腔镜手术与开腹手术治疗良性卵巢囊肿的临床观察[J].中国现代医生,2018,56(4):72-74.
[9]王粉玲,何莉茹,杜娟,等.腹腔镜与开腹卵巢囊肿剔除术治疗效果及其对卵巢功能影响的研究[J].中国医刊,2016,51(2):71-74.
[10]覃正文,郑会贤,任郁.腹腔镜与开腹卵巢囊肿剥除术对机体免疫功能及术后近远期卵巢功能的影响[J].海南医学院学报,2016,22(1):55-58.
[11]Amiri M,Kabir A,Nahidi F,et al.Effects of combined oral contraceptives on the clinical and biochemical parameters of hyperandrogenism in patients with polycystic ovary syndrome:a systematic review and meta-analysis[J].Eur J Contracept Reprod Health Care,2018,23(1):64-77.
[12]贺红菊,陈杰.免气腹腹腔镜手术在妊娠期卵巢囊肿中的应用[J].医学综述,2017,23(3):553-556.
[13]王秋荣.腹腔镜手术和开腹手术对卵巢囊肿患者凝血功能的影响[J].血栓与止血学,2017,23(4):654-655.
[14]王馥旭,丁雪梅,董春红,等.腹腔镜下卵巢囊肿剥除术对卵巢功能远期影响的临床研究[J].实用癌症杂志,2017,32(8):1367-1369.
[15]祖拉牙提·加帕尔,古丽努尔·阿不都克日木.腹腔镜对良性卵巢囊肿患者的治疗效果及对卵巢功能的影响探究[J].医学综述,2016,22(20):67-69.
[16]Yang R,Xu T,Fu Y,et al.Leiomyomatosis peritonealis disseminata associated with endometriosis:A case report and review of the literature[J].Oncol Lett,2015,9(2):717-720.
[17]姚永畅.腹腔镜与阴式卵巢囊肿剥除术对良性卵巢囊肿患者卵巢功能的影响[J].中国妇幼保健,2017,32(18):4585-4588.
[18]Park J Y,Kim D Y,Suh D S,et al.Laparoendoscopic singlesite versus conventional laparoscopic surgery for ovarian mature cystic teratoma[J].Obstet Gynecol Sci,2015,58(4):294-301.
[19]邱冰,王爱丽,曹立花,等.腹腔镜下卵巢囊肿剥除术对卵巢功能及性生活质量的影响[J].中国性科学,2017,26(9):65-68.
[20]王中显,白静,向媛媛,等.腹腔镜手术治疗老年卵巢囊肿临床疗效观察[J].中国实用妇科与产科杂志,2017,33(9):967-969.
[21]薛燕,郭晓莉,李春芳,等.腹腔镜微创手术对卵巢良性肿瘤患者机体创伤及卵巢功能的影响[J].河北医学,2017,23(2):215-218.