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目的:探讨腹腔镜下卵巢囊肿剔除术中电凝止血法和缝合止血法对卵巢功能及生活质量的影响,以期寻找一种对卵巢功能影响较小的止血方法,尽最大可能地保护患者的卵巢功能,提高患者的生活质量。方法:选取2014年3月—2016年4月在浦江县人民医院行腹腔镜下卵巢囊肿剔除术的100例病例,随机分为双极电凝止血组和缝合止血组各50例。观察两组患者的内分泌指标:卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2),改良的Kupermann评分,术中出血量和止血时间。结果:手术前,两组患者的FSH、LH、E2和改良的Kupermann评分等比较差异无统计学意义(P>0.05)。手术后3个月,两组患者的FSH、LH和改良的Kupermann评分均较术前升高,双极电凝组升高更明显,两组比较差异有统计学意义(P<0.05);两组患者的E2值均比术前降低,差异无统计学意义(P>0.05);两组患者的术中出血量和止血时间比较差异无统计学意义(P>0.05)。结论:腹腔镜下卵巢囊肿剔除术中电凝止血法和缝合止血法对卵巢功能及生活质量均有一定程度的影响。缝合止血对卵巢功能的损伤和对患者生活质量的影响程度小于双极电凝止血。镜下缝合是较为理想的创面止血方法。
OBJECTIVE: To investigate the effect of electrocorticoid hemostasis and suture hemostasis on ovarian function and quality of life during laparoscopic ovarian cyst excision in order to find out a hemostatic method with less effect on ovarian function, to protect the ovaries of patients as much as possible Function, improve the quality of life of patients. Methods: From March 2014 to April 2016, 100 cases of laparoscopic ovarian cyst excision in Pujiang People’s Hospital were randomly divided into bipolar coagulation group and suture hemostasis group, 50 cases each. The endocrine indexes of two groups were observed: FSH, LH, E2, modified Kupermann score, intraoperative blood loss and bleeding time. Results: Before operation, there was no significant difference in FSH, LH, E2 and modified Kupermann score between the two groups (P> 0.05). At 3 months after operation, the FSH, LH and modified Kupermann scores of both groups were significantly higher than those of preoperative and bipolar group. The difference between the two groups was statistically significant (P <0.05); two The E2 values of the two groups were significantly lower than those before operation (P> 0.05). There was no significant difference between the two groups in the amount of hemorrhage and bleeding time (P> 0.05). Conclusion: Laparoscopic ovarian cyst excision electrocoagulation hemostasis and suture hemostasis have a certain degree of ovarian function and quality of life. Suture hemostasis on ovarian function damage and quality of life of patients with less than the degree of bipolar coagulation hemostasis. Microsurgical stitching is the ideal method of wound hemostasis.