陈观美　徐晓青　张译文　王丽娟贵州省安顺市人民医院妇科，贵州安顺　561000

两种治疗方式对卵巢子宫内膜异位囊肿剥除术患者卵巢功能的影响

陈观美徐晓青张译文王丽娟
贵州省安顺市人民医院妇科，贵州安顺561000

目的 比较腹腔镜下两种不同手术方式在卵巢子宫内膜异位囊肿剥除术中对卵巢功能的影响。方法选择卵巢子宫内膜异位囊肿腹腔镜剥除术患者 160例。根据术中不同的手术方式分为单纯剥除术组（A组）、垂体后叶素盐水分离后剥除术组（B组），各80例。观察两组患者手术前后激素水平变化（FSH，FSH/LH，E2）及窦卵泡计数（AFC）及术中情况。比较两种不同的手术方式对卵巢储备功能的影响。结果 B组术中出血（30.0±1.4）mL，较A组少，手术时间（65.00±1.48）min较A组长，差异有统计学意义（P＜0.05）。A组术后激素水平FSH（9.46±0.30）U/L、E2（80.0±2.5）ng/L、FSH/LH（2.53±0.22）较术前升高，AFC（4.11±0.50）较术前降低，差异有统计学意义（P＜0.05）。B组术后激素水平FSH（6.23±0.20）U/L、E2（40.0±1.9）ng/L、FSH/LH（1.30±0.08）及AFC（8.0±0.6）与术前差异无统计学意义。术后 A组FSH，FSH/LH，E2均较B组高（P＜0.05），B组术后AFC计数较A组高（P＜0.05）。结论 在卵巢子宫内膜异位囊肿剥除术中，垂体后叶素盐水分离后剥除术较单纯剥除术更有利于卵巢储备功能的恢复。

腹腔镜；卵巢子宫内膜异位囊肿；垂体后叶素；卵巢储备

[Abstract]Objective To compare the effects of two different methods of laparoscopic surgery on ovarian function in patients with excision of ovarian endometriosis.Methods all 160 patients who were given laparoscopic resection of ovarian endometriosis cyst were selected.According to different surgical procedures，they were assigned to two groups：simple resection group（Group A）and group of resection after separation by pituitary hormone with saline（Group B），with 60 patients in each group.Changes of hormone levels（FSH，FSH/LH，E2），antral follicle count（AFC）and intraoperative condition in both groups of patients before and after the surgery were observed.The effects of two different surgical methods on ovarian reserve were compared.Results Less bleeding during operation was shown in group B，only 30±1.38 ml，and the operation time was（65±1.48）min.which was longer than that in Group A.The difference was statistically significant（P<0.05）.In Group A，postoperative hormone level of FSH was（9.46±0.3）（U/L），E2 was（80±2.5）（ng/L）and FSH/LH was（2.53±0.22），which were higher than those before surgery.AFC was（4.11± 0.53），which was lower than that before the surgery.The difference was statistically significant（P<0.05）.In Group B，postoperative hormone level of FSH was（6.23±0.25）（U/L），E2 was（40.0±1.9）（ng/L），FSH/LH was（1.30±0.08）and AFC was（8.00±0.65）.Above all，the difference was not statistically significant.After the surgery，FSH，FSH/LH and E2 in Group A were higher than those in Group B and the difference was statistically significant（P<0.05）.AFC in Group B after the surgery was higher than that in Group A（P<0.05）.Conclusion In the resection of ovarian endometriosis cyst，the resection after separation by pituitary hormone with saline is more favorable for the recovery of ovarian reserve than the simple resection.

[Key words]Laparoscopy;Ovarian endometriosis cyst;Posterior pituitary hormone;Ovarian reserve

卵巢子宫内膜异位囊肿是子宫内膜组织异位到卵巢引起的病灶，是一种常见的子宫内膜异位症，在育龄期女性中发病率极高[1]。虽是良性疾病，但具有侵袭性及复发率高等特点，易并发盆腔包块及不孕，损伤卵巢功能。腹腔镜下保守性手术已成为卵巢子宫内膜异位症的首选[2，3]。目前，腹腔镜卵巢手术中如何保护卵巢功能，已成为大家关注的焦点[4]。……