腹腔镜卵巢子宫内膜异位囊肿剥除术对卵巢储备功能的影响被引量：47

Influence on ovarian reserve function in women with ovarian endometriotic cyst after laparoscopic oophoro cystectomy

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摘要目的:探讨腹腔镜卵巢子宫内膜异位囊肿(巧囊)剥除术对卵巢储备功能可能造成的影响。方法:前瞻性对照研究,对照组:单侧卵巢成熟性囊性畸胎瘤行腹腔镜囊肿剥除术20例;实验组:卵巢子宫内膜异位囊肿行腹腔镜囊肿剥除术80例。实验组分为4组:A组:单侧巧囊<35岁(27例),B组:单侧巧囊≥35岁(13例),C组:双侧巧囊<35岁(28例)和D组:双侧巧囊≥35岁(12例)。比较各组手术前、手术后24h内血清FSH,LH,E2的变化并根据单侧巧囊的大小和类型分层分析。随访患者术后6月基础FSH的恢复情况,术后6月超声测量患者双侧卵巢的体积。结果:双侧各组(C,D两组)卵巢子宫内膜异位囊肿剥除术后24h内FSH较术前明显增高(P<0.05),E2明显减低(P<0.05),LH变化不明显。畸胎瘤组及单侧各组(A,B组)手术前后各激素水平均无统计学差异,分层分析单侧巧囊大小和类型,各组内组间激素水平变化亦无明显差异。C组患者术后6月基础FSH恢复至正常范围内占72.22%,而D组患者基础FSH恢复至正常范围内仅占55.56%,差异有统计学意义(P<0.05)。单侧卵巢囊肿剥除术后6月患侧与对侧卵巢缩小率均有显著差异(P<0.05),单侧卵巢囊肿剥除术后与双侧卵巢囊肿剥除术后患侧卵巢缩小率无统计学差异。结论:腹腔镜双侧卵巢子宫内膜异位囊肿剥除术对卵巢储备功能有一定的影响,但大部分患者可在术后6个月内恢复。 Objective：To investigate the impact on ovarian reserve function after laparoscopic excision of ovarian endometriotic cysts.Methods：A total of 100 women with ovarian cyst undergoing laparoscopic oophoro cystectomy were included.These patients were divided into five groups：20 patients with unilateral teratoma（control）,group A（n=27,unilateral ovarian endometriotic cyst,age35year）,group B（n=13,unilateral ovarian endometriotic cyst,age ≥35year）,group C（n=28,bilateral ovarian endometriotic cyst,age35year）and group D（n=12,bilateral ovarian endometriotic cyst,age≥35year）.Blood samples were obtained from patients before operation,after operation within 24h and on the 2nd or 3rd day of the menstrual cycle 6 months after operation.Mean ovarian diameters were evaluated by ultrasound 6 months after operation.Results：In the bilateral groups（C and D）,the serum level of FSH increased significantly after the operation（P0.05）,while E2 decreased significantly（P0.05）,for LH there was no significant difference.No significant difference between pre-and post-operation were observed in the unilateral groups（A and B）and control group.In group C,72.22% patients＇ serum bFSH recovered to normal 6 months after the operation,while 55.56% in group D.As to the reduction rate of mean ovarian diameter six months after operation,we could observe a significant difference between the affected and contralateral ovaries in unilateral groups（P0.05）.Anyhow,the reduction rate of affected ovaries in the bilateral and unilateral group showed no statistical difference.Conclusion：It suggested that ovarian reserve function would be decreased in laparoscopic bilateral ovarian endometriotic oophoro cystectomy.However,most patients recovered after 6 months.

作者史精华冷金花宋楠董喆郎景和

机构地区中国医学科学院中国协和医科大学北京协和医学院北京协和医院妇产科

出处《现代妇产科进展》 CSCD 北大核心 2010年第7期481-485,共5页 Progress in Obstetrics and Gynecology

关键词子宫内膜异位症腹腔镜卵巢囊肿剥除术卵巢储备功能激素卵巢体积 Endometriosis Laparoscopic oophoro cystectomy Ovarian reserve function Hormone Ovarian volume

分类号 R711.71 [医药卫生—妇产科学]

作者简介第一作者简介：史精华（1984-），女，中国医学科学院中国协和医科大学北京协和医学院北京协和医院妇产科在读博士研究生。主要研究方向：普通妇科。通讯作者Email：Lengjenny@vip．sina．com

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