腹腔镜行卵巢肿瘤剥除术后缝合止血与电凝止血的比较

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目的比较腹腔镜下行卵巢肿瘤剥除术后缝合止血与电凝止血两种方式对患者的影响。方法随机选择2012年6月-2014年6月至盐城市第一人民医院妇产科行腹腔镜下行卵巢肿瘤剥除术的患者120例,按照术后止血方式分为缝合组及电凝组。缝合组为剥除术后镜下行华丽康线连续锁边缝合。电凝止血组为剥除术后出血点双极电凝,功率30~40 W,每次2~3 s。观察两组患者的手术时间、术中出血量、术后排气时间,以及患者术前、手术时、术后6个月复诊是的FSH、LH、E2的数值。结果两组患者的手术时间、术中出血量以及术后排气时间的比较,差异均无统计学意义(P>0.05)。但电凝组有6例出现月经稀发,占11.11%,4例闭经,占7.41%,缝合组出现4例月经稀发,占6.06%,无闭经患者。电凝组出现月经稀发和闭经的比例明显高于缝合组,两组比较,差异有统计学意义(P<0.05)。两组患者的FSH、LH均比术前高(P<0.05),但是电凝组数值比缝合组的数值高的更明显(P<0.05)。术后6个月电凝组的FSH、LH在持续升高,与缝合组的数值差距更加明显,但是缝合组的数值缓慢回落,已经接近术前水平。但两组患者术前及术后的E2水平比较,差异无统计学意义(P>0.05)。结论两种术后止血方式对于患者手术时间、出血量及术后恢复时间没有影响,但是电凝止血对卵巢功能影响较大。 Objective To compare the effects of suture hemostasis and electrocoagulation hemostasis on patients after laparoscopic ovarian tumor removal. Methods A total of 120 patients undergoing laparoscopic ovarian tumor stripping from the Department of Obstetrics and Gynecology, First People’s Hospital of Yancheng from June 2012 to June 2014 were randomly divided into suture group and electrocoagulation group according to the way of postoperative hemostasis. Suture group for the removal of the postoperative gorgeous Kang Line continuous lock suture. Electrocoagulation and hemostasis group were bipolar coagulation after exsanguination, and the power was 30 ~ 40 W, 2 ~ 3 s each time. The operation time, intraoperative blood loss, postoperative exhaust time and FSH, LH and E2 of the two groups were observed before operation, during operation and 6 months after operation. Results There was no significant difference in the operation time, blood loss and postoperative exhaust time between the two groups (P> 0.05). However, there were 6 cases of hair loss in the electrocoagulation group, accounting for 11.11%, 4 cases of amenorrhea, accounting for 7.41%. There were 4 cases of oligomatous thinning in the suture group, accounting for 6.06%. The rate of oligomenorrhea and amenorrhea in the electrocoagulation group was significantly higher than that in the suture group, the difference was statistically significant (P <0.05). The FSH and LH of the two groups were higher than those before operation (P <0.05), but the values ​​of electrocoagulation group were higher than that of the suture group (P <0.05). At 6 months after operation, the FSH and LH of the electrocoagulation group continued to increase, and the difference with the suture group was more obvious. However, the values ​​of the suture group decreased slowly and approached the preoperative level. However, there was no significant difference between the two groups in preoperative and postoperative E2 levels (P> 0.05). Conclusion The two methods of postoperative hemostasis have no effect on the operation time, blood loss and postoperative recovery time. However, the hemostatic effect of electrocoagulation on ovarian function is greater.
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