摘要
目的:分析黄体破裂出血腹腔镜术中经缝合或双极电凝止血对患者应激激素、卵巢功能及免疫功能的影响.方法:2016年7月-2021年7月本院治疗的黄体破裂出血患者127例,根据腹腔镜手术止血方式分为缝合组66例(缝合止血法)、电凝组61例(双极电凝止血).对比两组手术指标、应激激素指标、卵巢功能激素指标、卵巢基质血流变及免疫功能指标水平及术后并发症发生情况.结果:电凝组手术时间(41.9±7.5min)、住院天数(3.2±0.9d)均短于缝合组(55.3±10.1min、4.8±1.4d),术中出血量(50.4±9.6ml)、术后VAS评分(3.0±0.9分)低于缝合组(86.4±12.8 ml、4.6±1.1分)(P<0.05);术后两组应激激素皮质醇(Cor)、醛固酮(ADL)水平均上升但电凝组低于缝合组,电凝组FSH、LH、E_(2)均升高且高于缝合组(P<0.05),缝合组E_(2)降低(P<0.05)而FSH、LH水平无变化(P>0.05),AFC、PSV缝合组较术前无差异,电凝组均下降且低于缝合组(P<0.05),两组CD3^(+)、CD4^(+)及CD8^(+)水平均下降但电凝组高于缝合组(均P<0.05),总并发症发生率缝合组(7.6%)低于电凝组(19.7%)(P<0.05).结论:两种止血方案各有优劣,手术缝合止血法对卵巢基质血流变及卵巢功能影响小,双极电凝止血更有利于抑制机体应激反应、保护免疫功能.
Objective: To analyze the influence of laparoscopic hemostasis by suture or bipolar electrocoagulation for treating patients with corpus luteum rupture on their stress hormone level,ovarian function,and immune function.Methods:127 patients with hemorrhage caused by corpus luteum rupture were included and were divided into group A(66 cases with suture hemostasis)and group B(61 cases with bipolar electrosurgery for hemostasis)according to the different hemostasis methods of laparoscopic surgery from July 2016 to July 2021.The surgical indexes,stress hormones levels,ovarian function,ovarian stromal hemorrhage,immune function indexes levels,and postoperative complications rate of the patients were compared between the two groups.Results:The operation time(41.9±7.5min)and the hospital stay(3.2±0.9d)of the patients in group B were significantly shorter than those(55.3±10.1min and 4.8±1.4d)of the patients in group A.The intraoperative blood loss(50.4±9.6ml)and the postoperative VAS score(3.0±0.9 points)of the patients in group B were significantly lower than those(86.4±12.8ml and 4.6±1.1)of the patients in group A(P<0.05).The Cor and ADL levels of the patients in both groups after operation had increased significantly,and which of the patients in group B were significantly lower than those of the patients in group A.The levels of FSH,LH,and E_(2) in both groups after operation had increased significantly,and which of the patients in group B were significantly higher than those of the patients in group A(P<0.05).The E_(2) level of the patients in group A after operation had decreased significantly(P<0.05),but the levels of FSH and LH of the patients in group A after operation had no changes(P>0.05).The values of AFC and PSV of the patients in group A after operation had no change,but which of the patients in group B after operation had decreased significantly and were significantly lower than those of the patients in group A(P<0.05).The levels of CD3^(+),CD4^(+)and CD8^(+)of the patients in both groups after oper
作者
曲长红
李广莹
倪换娟
周维
裴丽鹏
QU Changhong;LI Guangying;NI Huanjuan;ZHOU Wei;PEI Lipeng(Heping District Branch,General Hospital of Northern Theater Command,Shenyang,Liaoning Province,110000)
出处
《中国计划生育学杂志》
2022年第10期2228-2232,共5页
Chinese Journal of Family Planning
关键词
黄体破裂出血
腹腔镜手术
缝合止血法
双极电凝止血
手术指标
卵巢功能
应激激素
免疫功能
并发症
Corpus luteum rupture
Laparoscopic surgery
Suture hemostasis
Bipolar coagulation for hemostasis Operative indicator
Ovarian function
Stress hormone
Immune function
Complication
