卵巢子宫内膜异位囊肿手术方式探讨

Analysis on surgeries in ovarian endometriosis

目的 通过对开腹和腹腔镜下卵巢子宫内膜异位囊肿剥除术的比较 ,探讨腹腔镜在临床应用中的价值。方法 回顾性分析了 1 994年 1月～ 2 0 0 1年 8月于我院妇科施行的开腹和腹腔镜下卵巢子宫内膜异位囊肿剥除术的手术经验。两组病人术后随访 1 2～ 36个月。并对两组患者围手术期情况 ,术后症状缓解 ,复发率及妊娠率进行比较。结果 92例腹腔镜手术患者术中出血量 (1 1 0 5± 82 8)ml明显小于开腹组 (1 89 5± 96 8)ml,P <0 0 5。手术时间腹腔镜组 (1 36 5± 80 4 )min与开腹组 (1 4 8 5± 86 8)min相近 ,P >0 0 5。术后病率腹腔镜组 (4 92 ,4 3% )明显低于开腹组 (1 2 96 ,1 2 5 % ) ,P <0 0 5。术后下床活动及肛门排气时间腹腔镜组比开腹组明显缩短 ,P <0 0 5。随访术后妊娠率两组间差异有显著性 (P <0 0 5 )。结论 腹腔镜在子宫内膜异位囊肿诊断及治疗中具有安全、有效、微创的特点 。

Objective To compare cystectomy laparoscopicly and laparotomicly in treatment for ovarian endometriosis,and to evaluate laparoscopy in ovarian endometriosis therapy Methods Patients with ovarian endometriosis were separated into two groups,laparoscopic cystectomy and laparotomy cystectomy group,who were followed up postoperatively for 12～36 months The operative and postoperative situations,symptoms remission,pregnancy rate and disease recurrent rate were analyzed retrospectively Results The amount of blood lost during the operation in laparoscopic cystectomy was significantly less than that in laparotomy(110 5±82 8) ml vs (189 5±96 8) ml, P <0 05 The postoperative disease rate in laparoscopic group was significantly less than that in laparotomy (4/92,4 3% vs 12/96,12 5% P <0 05) The hospitalizaton time was significantly shorter in laparoscopic group The operation time was similar between the two groups There was significant difference in the pregnant rates after operation Conclusions laparoscopic diagnosis and treatment of endometriosis is safety,effective,micro-invasive and can be performed widely