腹腔镜电凝及超声刀止血方式对腹腔镜全子宫切除术患者性激素近期卵巢功能及免疫功能的影响

doi:10.3969/j.issn.1006-6233.2024.07.022

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Abstract Objective: To analyze the effects of laparoscopic unipolar and bipolar electrocautery and harmonic scalpel hemostasis on sex hormones, short-term ovarian function, and immune function in patients undergoing laparoscopic total hysterectomy. Methods: A total of 105 patients undergoing laparoscopic total hysterectomy in our hospital from October 2020 to December 2023 were selected and randomly divided into a unipolar and bipolar electrocautery group (n=53) and a harmonic scalpel group (n=52) using a simple random sampling method. The two groups were compared in terms of surgical indicators, sex hormones [luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E2)], ovarian function [maximum diameter (MOD), antral follicle count (AFC), ovarian artery peak systolic blood flow velocity (PSV)], immune function, and complications. Results: There was a statistically significant difference in intraoperative blood loss between the two groups (P<0.05). There was no statistically significant difference in the preoperative levels of LH, FSH, and E2 between the two groups (P>0.05). Postoperatively, LH and FSH levels increased in both groups compared to preoperative levels, and E2 levels decreased significantly in both groups compared to preoperative levels. Postoperatively, the differences in LH, FSH, and E2 between the unipolar and bipolar electrocautery group and the harmonic scalpel group were greater than those in the harmonic scalpel group (P<0.05). There was no statistically significant difference in MOD and PSV between the two groups preoperatively, and there was no statistically significant difference in AFC between the control group pre- and postoperatively (P>0.05). Postoperatively, MOD and PSV decreased in both groups compared to preoperative levels. Postoperatively, the differences in MOD, AFC, and PSV between the unipolar and bipolar electrocautery group and the harmonic scalpel group were greater than those in the harmonic scalpel group (P<0.05). There was no statistically significant difference in the preoperative levels of CD3⁺, CD4⁺, and CD8⁺ between the two groups (P>0.05). Postoperatively, CD3⁺, CD4⁺, and CD8⁺ levels decreased in both groups compared to preoperative levels. Postoperatively, the differences in CD3⁺, CD4⁺, and CD8⁺ between the unipolar and bipolar electrocautery group and the harmonic scalpel group were greater than those in the harmonic scalpel group (P<0.05). The incidence of menstrual abnormalities in the harmonic scalpel group was lower than that in the unipolar and bipolar electrocautery group (P<0.05). Conclusion: Laparoscopic unipolar and bipolar electrocautery and harmonic scalpel hemostasis have certain effects on sex hormones, short-term ovarian function, and immune function in patients undergoing laparoscopic total hysterectomy. However, the choice of hemostasis method should be based on the specific patient and the type and scale of the surgery.

Key words： Laparoscopy Unipolar and bipolar electrocautery Harmonic scalpel Sex hormones Ovarian function Immune function

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	GUI Dandan
	LU Bin
	TANG Shiqing

Cite this article:

GUI Dandan,LU Bin,TANG Shiqing. Effects of Laparoscopic Unipolar and Bipolar Electrocautery and Harmonic Scalpel Hemostasis on Sex Hormones, Short-Term Ovarian Function, and Immune Function in Patients Undergoing Laparoscopic Total Hysterectomy[J]. HeBei Med, 2024, 30(7): 1176-1181.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2024.07.022 OR http://www.hbyxzzs.cn/EN/Y2024/V30/I7/1176

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