关键词: 卵巢肿瘤, 性腺甾类激素, 止血, 手术, 评价研究

Abstract: Objective This study explores the influence of four ways in hemostasis on the ovarian function in ovarian cystectomy,including ultrasonic scalpel group,monopolar coagulation group, bipolar coagulation group and absorbable suture group. Methods Two hundred women undergoing ovarian cystectomy were divided randomly into four groups,50 cases each group,according to the hemostasis ways. Then,follicle-stimulating hormone( FSH ),luteinizing hormone( LH ),estradiol( E2 ) were examined,also antral follicle count( AFC)was detected with transvaginal color Doppler ultrasound at the second or third day of menstrual cycle before and after the operation 1 month,3 months,and 6 months,separately. Besides,all cases were followe up to observe the changes in the second menstrual crapms and the sixth-month menstrual condition after surgery. Results E2 level of all cases showed the trends of decrease and then increase. The decrease level was more apparent in monopolar coagulation and bipolar coagulation group,and it took a relatively longer time to recover. The decrease was the least and the recovery was the fastest,and the level of E2 was close to the preoperative level six months after surgery in absorbable suture group. FSH and LH were all increased apparently in four groups and then decreased slowly,they were more close to the preoperative level after six months of surgery in absorbable suture group. And it was still higher apparently than the preoperative level in monopolar coagulation and bipolar coagulation group after six months. The level of E2 ,FSH and LH of four groups all showed statistical significance among groups,time and the interaction(P<0. 01). The AFC of all the groups was decreased and then recovered to the preoperative level after six months of surgery. The recovery was more rapid in absorbable suture group. Menstrual changes were mainly demonstrated as extended menstrual cycle,a decrease in menstrual quantity,accompanies with occasional menstrual extension,slight hot flashes sweating,and agitation. However,at six months after surgery,the above mentioned symptoms generally disappeared and menstrual returned to normal. There were no patents suffering from amenorrhoea and severe menopausal transition. Conclusion Compared with the hemostasis of ultrasonic scalpel,monopolar coagulation and bipolar coagulation,absorbable suturation in ovarian cystectomy had the advantages of less injury to the ovarian and faster postoperative recovery.

Key words: ovarian neoplasm, gonadal steroid hormones, hemostasis surgical, evaluation studies