中重度子宫内膜异位症腹腔镜术后腹痛程度评估分析

The Evaluation of Changes in Pelvic Pain After Laparoscopic Surgery for Moderate and Severe Endometriosis

【目的】通过术后3～12个月随访患者术前、术后疼痛评分改变及术后满意度为主要疗效评定方法进行研究,探讨Ⅲ～Ⅳ期中重度子宫内膜异位症(EMs)病灶的腹腔镜手术治疗效果。【方法】采用视觉模拟评分法(VAS)对疼痛进行评分,要求患者按疼痛程度记录术前及术后3、6和12个月痛经、慢性盆腔痛及深部性交痛的发生及程度。【结果】慢性盆腔痛、痛经、深部性交痛的评分在术后3个月都有明显下降,术前疼痛评分在术后3个月均有显著下降,术前慢性盆腔痛、痛经、深部性交痛评分分别为4.69±0.38(69例)、5.66±0.31(68例)、1.96±0.33(58例),术后分别为2.26±0.19(69例)、4.39±0.25(57例)、2.14±0.26(55例),且持续术后12个月。无任何手术并发症,其中59例(85.5%)患者表示对手术效果满意(5～8分)或十分满意(9或10分),9例(13.0%)患者对手术效果不满意(5分以下)。【结论】Ⅲ～Ⅳ期EMs病灶行腹腔镜手术是缓解腹痛的有效方法。

[Objeetive]To evaluate the changes in pelvic pain after ablative laparoscopic surgery, both the patient pain scores and satisfaction were included. [Methods]Sixty-nine consecutive women with stage Ⅲ～Ⅳ endometriosis all underwent laparoseopic sugery. Preand postoperative visual analogue scores for pelvic pain were recorded. Patient satisfaction after the sugery was included. [Results]A total of 69 women with stageⅢ～ Ⅳ endometriosis and 96 cysts （23 cysts were bilateral） showed reduction in the pain scores Meaningful improvements and relief in clinical symptoms were obtained with laparoseopic surgery. No surgieal complications occurred and 85.5 % patients were satisfied with the treatment. [Conelusion]Laparoscopic ablation of endometriosis significantly reduces pain and improves quality of life.