保守性手术引起术后卵巢早衰的相关原因分析
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摘要
目的探讨保守性手术引起术后卵巢早衰的相关原因。方法选择本院2009年1月~2013年10月收治的卵巢囊肿术后出现卵巢早衰的患者30例为研究组,选择同期卵巢囊肿术后未出现卵巢早衰的患者30例为对照组,分析比较两组激素水平,以及手术方式、术中出血、囊肿大小以及卵巢残留体积。结果研究组雌二醇水平低于对照组(P<0.05),卵泡刺激素及黄体生成素水平均明显高于对照组(P<0.05)。研究组患者手术前卵巢囊肿体积大于对照组,术中出血量多于对照组,术后残留卵巢体积小于对照组,开腹手术率及腹腔镜手术率低于对照组,差异有统计学意义(P<0.05)。结论卵巢囊肿体积较大、术中出血多、残留卵巢组织较少,可能是导致术后卵巢早衰的主要因素,提示临床在处理卵巢囊肿时尽量选择微创手术,尽量保留正常卵巢组织,术中避免损伤卵巢主要血管,以防止术后出现卵巢早衰。
Objective To investigate the related causes of premature ovarian failure after conservative surgery.Methods 30 cases of patients with premature ovarian failure after conservative ovarian cyst surgery from January 2009 to October 2013 were selected as study group,30 cases of patients with no premature ovarian failure in same period were selected as control group,the hormone levels and surgical blood loss,ovarian cyst size and residual volume of two groups were compared.Results The estradiol of study group was lower than that of the control group(P<0.05),follicle-stimulating hormone and luteinizing hormone was significantly higher than that of control group respectively(P<0.05).Ovarian cyst volume of study group before surgery was higher than that of the control group,blood loss was more than that of the control group,postoperative residual ovarian volume was smaller than that of the control group,laparotomy rate and the laparoscopic surgery rate was lower than that of control group,the difference was significant(P<0.05).Conclusion Larger ovarian cysts,more bleeding,less residual ovarian tissue may be the major factors leading premature ovarian failure after surgery,it suggests that the clinic should choose minimally invasive surgery in treatment of ovarian cysts,preserve normal ovarian organization,avoid ovarian major vascular injury,prevent postoperative premature ovarian failure.
Objective To investigate the related causes of premature ovarian failure after conservative surgery.Methods 30 cases of patients with premature ovarian failure after conservative ovarian cyst surgery from January 2009 to October 2013 were selected as study group,30 cases of patients with no premature ovarian failure in same period were selected as control group,the hormone levels and surgical blood loss,ovarian cyst size and residual volume of two groups were compared.Results The estradiol of study group was lower than that of the control group(P<0.05),follicle-stimulating hormone and luteinizing hormone was significantly higher than that of control group respectively(P<0.05).Ovarian cyst volume of study group before surgery was higher than that of the control group,blood loss was more than that of the control group,postoperative residual ovarian volume was smaller than that of the control group,laparotomy rate and the laparoscopic surgery rate was lower than that of control group,the difference was significant(P<0.05).Conclusion Larger ovarian cysts,more bleeding,less residual ovarian tissue may be the major factors leading premature ovarian failure after surgery,it suggests that the clinic should choose minimally invasive surgery in treatment of ovarian cysts,preserve normal ovarian organization,avoid ovarian major vascular injury,prevent postoperative premature ovarian failure.
引文
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[9]徐肖文,吕杰强,周洁,等.不同术式的卵巢保守性手术对卵巢储备功能的影响[J].温州医学院学报,2003,33(4):233-234.
[2]王长娟,李宏,单晶,等.卵巢早衰的病因分析及防治[J].中国实用医药,2013,8(14):94-95.
[3]雷贞武,陈子江.妇产科学[M].2版.北京:人民军医出版社,2003:248.
[4]莫中福,徐素欣.卵巢早衰病因及诊治的研究进展[J].河北医科大学学报,2006,27(3):230-233
[5]张金玉.卵巢肿瘤剔除术对体外受精-胚胎移植中卵巢反应性影响[J].中国实用妇科与产科杂志,2003,19(5):283-284.
[6]Garcia-Velasco JA,Mahutte NG,Corona J,et al.Removal of endometriomas before in vitro fertilization does not improve fertility outcomes:a matched,case-control study[J].Fertil Steril,2004,81(5):1194-1197.
[7]崔淑娟,郭艳蒲,高艳华.卵巢囊肿术后卵巢早衰的临床研究[J].现代预防医学,2011,38(10):1836-1837.
[8]季慧玲,邵敬於.卵巢保守性手术后卵巢早衰临床分析[J].现代妇产科进展,2001,10(4):261-263.
[9]徐肖文,吕杰强,周洁,等.不同术式的卵巢保守性手术对卵巢储备功能的影响[J].温州医学院学报,2003,33(4):233-234.