| [Objective]With the wide range of laparoscopic techniques used in gynecological surgery,laparoscopic resection has become one of the preferred methods for the treatment of ovarian cysts in women of childbearing age.Currently,what kind of hemostasis method is used clinically to reduce the ovarian reserve There is no unanimous conclusion about the recent effects of the function.In this paper,we compare the effects of two methods of hemostasis and suture hemostasis on the ovarian function in patients undergoing laparoscopic ovarian cyst excision to provide some theoretical basis for choosing the method of hemostasis in ovarian cyst excision.[Methods]The study selected 220 patients who underwent laparoscopic ovarian cyst excision in our hospital from January 2016 to December 2017.The patients were randomly divided into coagulation group(n=110)and suture group(n=110).Patients with electrocoagulation during laparoscopic ovarian cyst excision Blood coagulation method,suture group in laparoscopic ovarian cyst removal surgery using suture hemostasis method.The levels of estradiol E2,follicle puncture hormone FSH,luteinizing hormone LH and Anti-mullerian hormone AMH were measured before operation,one month after operation and three months after operation.,Antral follicle count,peak ovarian stromal flow,and ovarian volume,to assess the effect of two hemostatic methods on recent ovarian function in patients.[result]1.Comparison of general data between the two groups before surgeryThe preoperative data of the patients were not significantly different between the two groups in terms of age,BMI,ovarian cyst diameter,menstrual cycle,menstrual period,fertility,and number of single and bilateral cysts,and were not statistically significant(P>0.05)2.Comparison of intraoperative and postoperative resultsThere was no significant difference in intraoperative blood loss between the electrocoagulation group and the suture group(P>0.05).The bleeding volume of the bilateral cyst patients was more than one side,but the difference was not significant(P>0.05).The patients in the electrocoagulation group The operation time was significantly shorter than that of the suture group,and the difference was significant(P<0.05).3.The two groups of patients based on the comparison of hormonesThere was no significant difference in preoperative levels of E2,FSH,and LH between the two groups(P>0.05);FSH and LH levels increased significantly and E2 levels decreased significantly in both groups at one month and three months after operation.The level of E2 in the suture group was significantly higher than that in the electrocoagulation group.The levels of FSH and LH in the suture group were significantly lower than those in the electrocoagulation group(P<0.05).4.Comparison of hormone levels in patients with unilateral and bilateral ovarian endometriotic cysts and other types of cysts on one sidePatients with unilateral ovarian endometriosis cysts had higher AMH and E2 than patients with bilateral ovarian endometriosis cysts.FSH and LH were lower than bilateral patients,but the difference was not statistically significant(P>0.05).The levels of AMH and E2 in serum of patients with other types of cysts were higher than those of patients with unilateral ovarian endometriosis.FSH and LH were lower than those of bilateral patients,but the difference was not statistically significant(P>0.05).Patients with bilateral ovarian endometriotic cysts had lower AMH and E2 than patients with unilateral ovarian cysts at 1 month and 3 months after surgery.FSH and LH were higher than those in unilateral ovarian cysts.More significant,statistically significant(P<0.05);unilateral other types of cysts in patients with serum AMH,E2 levels higher than unilateral ovarian endometriosis cysts,FSH,LH is lower than bilateral patients,and the difference Not statistically significant(P>0.05).5.Expression of AMH and FSH in patients of different ages before and after operationThe expression level of AMH in serum decreased with age,the highest expression level in the 20-24 year old group,and the lowest in the 35-39 year old group(P<0.05).The expression of FSH increased with age,the expression level was the lowest in the 20-24 age group,and the highest in the 35-39 age group,the difference was statistically significant(P<0.05).6.The two groups of patients with antral follicle count and ovarian volume comparisonThe vaginal ultrasonography showed that there was no significant difference in preoperative antral follicle count between the two groups(P>0.05).The mean ovarian volume,sinus follicle count and preoperative time were 1 month and 3 months after operation in the suture group.The difference was statistically significant(P<0.05);the mean value of ovarian interstitial blood flow increased at 1 month after operation and 3 months after operation,the difference was statistically significant(P<0.05);electrocoagulation The mean ovarian volume and sinus follicle counts were significantly lower in the 1 month and 3 months after surgery,and the difference was statistically significant(P<0.05).The mean ovarian interstitial blood flow was in the operation.There was no significant difference between the first month and the third month after operation(P>0.05).The average antral follicle count,ovarian volume and ovarian interstitial blood flow were significantly higher in the suture group.In the electrocoagulation group,the difference was statistically significant(P<0.05).7.The two groups of patients with ovarian reserve function comparison In the electrocoagulation group,2 cases of ovarian reserve function decreased after operation,1 case of ovarian reserve failure,the total incidence rate was 2.7%,and the age of ovarian premature aging was 38 years old,which was a bilateral ovarian cyst removal surgery.amenorrhea and menstrual thinning,FSH 42.3 IU/L;2 cases of ovarian reserve function decreased in the suture group,0 cases of ovarian reserve failure,the total incidence of 1.8%,the two groups of patients The difference was not statistically significant(P>0.05)[in conclusion]1.The use of electrocatalytic hemostasis and suture hemostasis in laparoscopic ovarian cyst excision in patients with recent ovarian reserve have a certain impact.2.Ovarian hemostasis can be effectively prevented by using suture method during laparoscopic ovarian cyst excision.Ovarian tissue damage can be avoided effectively and postoperative recovery of ovarian function is acceptable.3.In laparoscopic ovarian cyst excision,ovarian hemostasis patients with sex hormone recovery by suture method,the average ovarian volume,ovarian stromal blood flow peak mean value was significantly better than the coagulation and coagulation method.4.There was no significant difference in ovarian reserve function between patients with unilateral endometriotic cysts and other unilateral ovarian cysts after laparoscopic stripping.5.The bilateral ovarian cysts have a significant impact on the ovarian reserve function after unilateral ovarian cyst excision.6.There was no significant difference in ovarian reserve function between patients with unilateral endometriotic cysts and other unilateral ovarian cysts after laparoscopic stripping.7.The ovarian reserve function evaluation index,AMH is more sensitive and more direct than FSH,L H,E2.8.In the process of laparoscopic treatment of benign ovarian tumors,the best hemostasis can be selected according to the patient’s specific clinical conditions and the extent of the lesion... |
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