涂文菲

[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。

[关键词] 卵巢囊肿；保守性手术；卵巢早衰；原因分析

[中图分类号] R713.6[文献标识码] B[文章编号] 1674-4721（2014）05（a）-0162-03

Related causes of premature ovarian failure after conservative surgery

TU Wen-fei

The First People′s Hospital of Jingdezhen City in Jiangxi Province,Jingdezhen 333000,China

[Abstract] 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.

[Key words] Ovarian cysts;Conservative surgery;Ovarian failure

卵巢早衰是指卵巢功能衰竭所导致的40岁之前即闭经的现象，表现为原发或继发闭经伴随血促性腺激素水平升高和雌激素水平降低，并伴有不同程度的一系列低雌激素症状。目前关于卵巢早衰的具体发病机制临床尚不明确，有研究认为生育期卵巢保守性手术可能是造成卵巢早衰的影响因素[1]。临床实践显示多数生育年龄的患者行卵巢保守性手术后，保留的卵巢组织仍有正常功能，少数患者会出现术后卵巢早衰，对患者术后生活质量造成严重影响，应该引起临床重视[2]。……