| Objections:Endometriosis,EMT for short,which can be diagnosed by laparoscopy,operation and medication as the "gold standard" treatment.Laparoscopic ovarian chocolate cyst removal is preferred method for patients with ineffective drug therapy,young age and fertility requirements.Laparoscopic chocolate cyst removal decreases ovarian reserve,even resulting in premature ovarian failure(POF).It is the clinical focus that is to figure out how to reduce the extent of surgery damage to ovarian reserve function.The purpose of this research is to study the effect of diluted vasopressin which is injected during laparoscopic chocolate cyst removal on ovarian reserve function,so as to conduct a meta-analysis and provide reference for optimizing clinical treatment plan.Research Methods:After laparoscopic separation of pelvic adhesions and restoration of anatomical position,the experimental group adopted diluted pituitrin(for example,dilute 6 U pituitrin to 50-60 ml with normal saline,with different dilution ratios in different studies)which was injected into the wall space between the ovarian cortex and the ovarian cyst for stripping,and paid attention not to inject it into the vascular area.Routine stripping was used in the control group,without the injection technique.According to strict inclusion and exclusion criteria,The Cochrane Library,Pub Med,EMbase,Web of Science,Wan Fang,CBM,VIP and CNKI databases were searched from the establishment of database to December 2018.Relevant RCT literatures were searched and references of the included literatures were tracked.End Note 9 software was used to import,screen duplicate literatures and extract data.Finally,13 literatures were included,including 11 Chinese literatures and 2 English literatures.Meta analysis was performed with Rev Man5.3 after extracting data.Results:There was no statistically significant difference between the two groups comparing preoperative outcome indexes.FSH levels at 1 month after surgery、postoperative LH levels 、E2 levels at 1 and 3 months after surgery and PSV at 6 months after surgery between two groups were no statistically significant differences.Postoperatively,FSH levels at 3 months and 6 months after surgery were higher than preoperative baseline,and which in the control group were significantly higher than in the experimental group.The E2 control group was lower than vasopressin group 6 months after surgery,which was significant statistically.AMH 3 months after surgery,AFC 6 months after surgery and ovarian volume decreased compared with that before surgery,and the result of the experimental group was higher than the control group,with significant differences statistically.Compared to the control group,the experimental group had more favorable results in terms of the general intraoperative indicators(intraoperative blood loss,electrocoagulation frequency,and postoperative thickness of residual ovarian tissue remaining on capsule wall),with significant statistically differences.Laparoscopic ovarian chocolate cyst removal of intraoperative injection diluted pituitrin compared with conventional operation,the "water cushion" tension makes the anatomy of the surgical area clear,which is able to remain normal ovarian tissue effectively and reduces the bleeding loss,thus it is available to reduce the frequency of using intraoperative energy equipment,decrease the thermal damage of ovary and the damage to the ovarian reserve function.Conclusions:1.Laparoscopic chocolate cyst of ovary cystectomy can damage the ovarian reserve function of patients,nonetheless intraoperative vasopressin injection technique is able to reduce the damage of ovarian reserve function effectively.2.Laparoscopic chocolate cyst of ovary cystectomy injecting vasopressin is available to reduce intraoperative blood loss,intraoperative electrocoagulation frequency,and postoperative thickness of residual ovarian tissue remaining on capsule wall,which contributes profits to patients obviously,worthy of clinical promotion. |
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