卵巢子宫内膜异位囊肿合并不孕患者两种保守手术治疗方法研究

Evaluation of two conservative operations for ovarian endometrial cyst with infertility

目的评价腹腔镜下与剖腹囊肿剥出术对卵巢子宫内膜异位囊肿(简称内异囊肿)合并不孕的疗效。方法108例卵巢内异囊肿合并不孕患者接受两种手术治疗,腹腔镜下卵巢囊肿剥出术组61例,剖腹囊肿剥出术组47例,分别比较两组患者的手术时间、术中出血量、肛门排气时间和住院天数,同时随访术后妊娠率和复发率。结果腹腔镜下囊肿剥出术组平均手术时间、术中出血量、肛门排气时间、住院天数、术后妊娠率分别为(46.5±18.3)min、(53.0±20.5)ml、(14.2±4.25)h、(2.91±0.99)d和40.0%,剖腹手术组分别为(76.3±28.2)min、(120.8±35.5)ml、(25.5±4.34)h、(5.67±1.60)d和20.5%,两组比较差别有显著性意义(t?χ2=3.23、4.95、1.86、6.31和4.34,均P<0.05)。两组复发率分别为9.1%、9.3%,差别无显著性意义(χ2=0.03,P>0.05)。结论对于卵巢子宫内膜异位囊肿合并不孕者,腹腔镜下囊肿剥出术较剖腹手术具有更大的优越性。术后及时助孕治疗有助于提高妊娠率。

Objective To evaluate the clinical effect of ovarian endometrial cystectomy with laparotomy or laparoscopic operation. Methods One hundred and eight cases of ovarian endometrial cyst with infertility underwent two approaches of cystectomy 61 cases received laparoscopic operation and 47 cases received laparotomy. The operative duration blood loss recovery and pregnancy rate with two approaches were retrospectively reviewed and compared. Results Patients who received laparoscopic cystectomy had higher pregnancy rate(40.0% vs 20.5% χ2=4.34,P<0.05) less blood loss(53.0±20.5)ml vs (120.8±35.5)ml t=4.95,P<0.05) quicker gas void(14.2±4.25)h vs (25.5±4.34)h t=1.86,P<0.05) shorter operative duration (46.5±18.3)min vs (76.3±28.2)min t=3.23,P<0.05),and shorter hospitalization(2.91±0.99)d vs (5.67±1.60)d,t=6.31 P<0.01). The recurrence rate of cyst was same in two groups. Conclusion Laparoscopic cystectomy has more advantage in treatment of ovarian endometrial cyst with infertility over the laparotomy.