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目的探讨卵泡期、黄体期行腹腔镜卵巢囊肿切除对卵巢功能的影响。方法选择本院2013年5月—2014年10月收治的单侧卵巢囊肿患者76例,根据患者腹腔镜卵巢囊肿切除时所处不同月经时相分为黄体期组32例、卵泡期组44例。两组均行腹腔镜下卵巢囊肿剥除术,观察两组患者术前卵巢血流情况、术中出血量、手术时间及手术前后激素水平变化情况。计量资料组间比较采用t检验,组内比较采用配对t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果黄体期组卵泡周围血流阻力指数(resistance index,RI)为(0.41±0.20),明显低于卵泡期组的(0.62±0.17),卵巢间质动脉血流收缩期峰值流速(peak systolic velocity,PSV)为(35.7±3.5)cm/s,明显高于卵泡期组的(31.1±2.4)cm/s,差异均有统计学意义(均P<0.05)。黄体期组术中出血量为(54.4±16.5)ml,明显多于卵泡期组的(26.5±11.2)ml,差异有统计学意义(P<0.05)。黄体期组术后黄体生成素、卵泡刺激素水平分别为(15.1±2.3)、(7.8±0.8)U/L,较术前的(7.8±1.5)、(4.2±0.8)U/L明显升高,雌二醇水平为(58.2±11.9)mmol/L,较术前的(101.8±11.9)mmol/L明显降低,差异均有统计学意义(均P<0.05)。结论黄体期卵巢血运较卵泡期丰富,此期进行卵巢囊肿切除出血较多,止血相对困难,且黄体期手术会影响各激素水平,进而影响卵巢功能。因此,卵巢囊肿建议选择卵泡期切除。
Objective To investigate the effect of laparoscopic ovarian cyst excision on ovarian function in follicular phase and luteal phase. Methods 76 patients with unilateral ovarian cysts admitted to our hospital from May 2013 to October 2014 were enrolled in this study. According to the different periods of laparoscopic ovarian cysts, 32 cases were divided into luteal phase group, 44 follicular phase group . Laparoscopic ovarian cyst excision was performed in both groups. Preoperative ovarian blood flow, blood loss, operation time and hormone levels before and after surgery were observed. Measurement data were compared between groups using t test, the group was compared using paired t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results The luteal flow resistance index (RI) of the luteal phase group was (0.41 ± 0.20), which was significantly lower than that of the follicular phase group (0.62 ± 0.17). The peak systolic velocity of ovarian interstitial artery , PSV was (35.7 ± 3.5) cm / s, which was significantly higher than that of the follicular phase (31.1 ± 2.4) cm / s, all of which had statistical significance (all P <0.05). The amount of bleeding in luteal phase group was (54.4 ± 16.5) ml, which was significantly higher than that in follicular phase group (26.5 ± 11.2) ml, the difference was statistically significant (P <0.05). The levels of luteinizing hormone and follicle stimulating hormone in the luteal phase group were (15.1 ± 2.3) and (7.8 ± 0.8) U / L, respectively, which were significantly higher than those of preoperative (7.8 ± 1.5) and (4.2 ± 0.8) U / L High and estradiol levels were (58.2 ± 11.9) mmol / L, which were significantly lower than those preoperatively (101.8 ± 11.9) mmol / L, both with statistical significance (all P <0.05). Conclusions Luteal phase ovarian blood supply is more abundant than follicular phase. In this period, ovarian cyst resection and hemorrhage is relatively more difficult to stop bleeding, and luteal phase surgery will affect the hormone levels, thus affecting ovarian function. Therefore, ovarian cysts suggest the choice of follicular phase excision.