目的探讨腹腔镜下双侧卵巢子宫内膜异位囊肿行腹腔镜剔除术中残存卵巢的处理措施,其对术后卵巢功能以及妊娠的影响。方法选择行双侧卵巢子宫内膜异位囊肿剔除术患者99例,根据术中处理残留卵巢的不同方法分为3组,分别为单极电凝组(单凝组)、双极电凝组(双凝组)及缝合组,每组33例,比较各组手术前后的雌二醇(E2)、卵泡刺激素(FSH)、黄体生成素(LH)和窦卵泡计数(AFC),以及术后随访月经情况。结果 3组术后均出现血清E2和AFC降低,FSH和FSH/LH增高,术后FSH、FSH/LH、E2及AFC值比较,单凝组与双凝组、缝合组比较差异有统计学意义(P<0.01);术后FSH、FSH/LH、E2比较,双凝组与缝合组比较差异有统计学意义(P<0.05),两组术后AFC值比较及各组手术前后血清LH比较差异无统计学意义(P>0.05)。单凝组与缝合组患者月经周期改变比较差异有统计学意义(P<0.05)。缝合组患者术后妊娠能力优于单凝组,差异有统计学意义(P<0.01)。结论腹腔镜下卵巢子宫内膜异位囊肿剔除术中使用缝合法能够最大程度保护卵巢功能及储备功能,改善患者术后生育能力。

Objective To discuss the treatment of residual ovarian parenchyma with laparoscopic ovarian endometriosis cyst eliminate on bilateral ovarian,and the influence on ovarian function and pregnancy after surgery. Methods 99 patients with bilateral ovarian endometriosis cyst surgery were selected. Three groups were divided according to different methods of ovarian residue during operation,and there were 33 cases in monopolar electric coagulation group( Dan Ningzu),bipolar electric coagulation group( double coagulation group) and suture group respectively. the index of estradiol( E2),follicle stimulating hormone( FSH),luteinizing hormone( LH),antral follicle count( AFC) and postoperative follow-upperiod pregnancy were compared before and after the operation in each group. Results The patients after operation of 3 groups all showed serum E2 and AFC decreased,FSH and FSH / LH increased.Single coagulation group compared with double coagulation group,suture group in FSH,FSH / LH,E2 and AFC after operation,the difference was statistically significant; double coagulation group compared with suture group in FSH,FSH / LH,E2 after operation,the difference was statistically significant,The single coagulation group compared with suture group patients in menstrual cycle,difference was statistically significant. Suture group patients after pregnancy ability was better than the single coagulation group. Conclusion Laparoscopic cystectomy for ovarian endometriotic cyst with suture can protect ovarian function andimprove fertility of postoperative patients.