Different Hemostasis Methods Of Ovarian Cyst Dissection Combined With GnRH-a Treatment Clinical Analysis Of Chocolate Cyst Of Ovary

Research background and purpose:The "chocolate cyst of ovary" formed by endometriosis(EMS)seriously affects the health and quality of life of young and middle-aged women.It is of great significance to study this disease for women’s physical and mental health.Treatment of ovarian chocolate cyst basically has operation,drug treatment,complementary with drug treatment after operation,because inside different disease pathological change is diverse,have very strong relapse sex and the characteristic such as sex hormone dependence,etiology is still not clear,so radical cure is difficult.Various treatment methods have certain side effects.Drug treatment includes liver and kidney function damage,perimenopausal syndrome,irregular vaginal bleeding,etc.Surgical treatment includes affecting ovarian function,postoperative recurrence,etc.Through the analysis of women ovarian chocolate cyst surgical suture with different electric coagulation hemostasis method after subcutaneous injection of gonadotropin-releasing hormone analogue(GNRH-a)once every 28 days,the treatment effect of 3 times in a row,so that the improvement in clinical symptoms,reduce discomfort,reduce recurrence,save the ovarian function,provide the basis for the standardized management of endometriosis,maximize promote the protection of women’s health,improve the quality of life of patients.Materials and Methods:Retrospective analysis was performed on 103 patients with chocolate cyst of childbearing age who were treated in the Department of Gynecology of Chengdu Fifth People’s Hospital from January 2018 to June 2020.According to different hemostasis methods after cyst dissection,they were divided into electrocoagulation hemostasis group(n = 52)and suture hemostasis group(n = 51).General data of the subjects were collected,including admission number,age,fertility history,dysmenorrhea history,chronic pelvic pain history,cyst size,and CA125.Patients in stage III-IV undergoing unilateral laparoscopic chocolate cyst excision and postoperative treatment with Gn RH-a were selected for this study,and the efficacy and adverse reactions of the two groups were analyzed and compared half a year later.Result:1.The operative time(P=0.197)and blood loss(P=0.271)of the electrocoagulation hemostasis group and the suture hemostasis group were both P>0.05,showing no statistical difference.The intraoperative effects of the two surgical methods were similar.2.After treatment,the dysmenorrhea symptom score of the two groups was significantly reduced.The dysmenorrhea symptom score of the electrocoagulation group was significantly lower than that of the suture group(7.69 ± 3.55),P=0.001<0.05,indicating that the electrocoagulation group had a more obvious effect on dysmenorrhea.3.The symptom scores of chronic pelvic pain in both groups decreased after treatment.The score of chronic pelvic pain in the electrocoagulation group was 1.87±2.01 after treatment,and that in the suture group was 1.73±1.28 after treatment.4.Comparison of the overall therapeutic effects between the two groups showed that 9 cases were cured,16 cases were significantly effective,23 cases were effective,and 4 cases were ineffective,with an effective rate of 92.31% in the electrocoagulation group;8 cases were cured,12 cases were significantly effective,26 cases were effective,and 5 cases were ineffective,with an effective rate of 90.20% in the suture group,P=0.841>0.05 in the two groups.There was no significant difference in the therapeutic effect between the two groups.5.Compared two groups of adverse reaction happening,electric coagulation group of perimenopausal symptoms occur in 49 cases,5 cases were irregular vaginal bleeding,liver and kidney dysfunction in 4 cases,allergic skin rash for 3 cases,suture group of perimenopausal symptoms occur in 41 cases,irregular vaginal bleeding in 8 cases,liver and kidney dysfunction in 2 cases,allergic skin rash in 2 cases,perimenopausal symptoms(P =0.028 < 0.05,irregular vaginal bleeding,P = 0.390 > 0.05,liver and kidney dysfunction(P =0.678 > 0.05,allergic skin rash(P = 1.000 > 0.05.The KMI scores of the electrocoagulation group and the suture group were 13.37±5.99 and 9.53±6.66,respectively,P=0.03<0.05,which was statistically significant.The results showed that the KMI score of the electrocoagulation group was higher than that of the suture group.Patients with symptoms of perimenopausal syndrome had more obvious symptoms.Other adverse reactions Irregular vaginal bleeding,abnormal liver and kidney function,allergic rash had no significant difference.Conclusion:There was no statistically significant difference in time or blood loss between the two procedures.Both treatments are effective for dysmenorrhea and chronic pelvic pain.In terms of improving dysmenorrhea symptoms,electrocoagulation hemostasis group was better than suture hemostasis group.The incidence of perimenopausal adverse reactions was higher and the symptoms were more obvious in the electrocoagulation hemostasis group.Clinically,the appropriate surgical methods can be selected according to the patient’s age,fertility needs,clinical symptoms and signs,so as to maximize the efficacy of patients’ benefits.