腹腔镜检查对妇女慢性盆腔痛病因诊断的价值

Diagnostic value of Laproscopy for Etiology of chronic pelvic pain in Women

选择142例慢性盆腔痛妇女为研究对象，评价腹腔镜检查对慢性盆腔痛病因诊断的价值。结果：临床检查发现本组中120例由5种妇科病因引起（84．51％），6例精神因素（4．23％），16例病因不明（11．28％）。腹腔镜检查发现有130例由8种妇科病因引起（91．55％），5例外科因素（4．23％），2例精神因素（1．41％），5例病因不明（4．23％）；盆腔痛最常见的病因为慢性盆腔炎症（40．14％）和盆腔子宫内胜异位症（32．39％）。腹腔镜检查证实两者临床误诊率分别为28．75％和30．30％，相互误诊率为19．12％。其他病因如阔韧带筋膜撕裂和外科性病因的临床误诊率达100％。提示：妇女慢性盆腔痛病因复杂，临床检查容易同诊和误诊，腹腔镜检查对明确病因有极高的价值。

Etiology of chronic pelvic pain was researched in 142 female patients by using laparoscopy. The results showed as follows: The preoperative pelvic examination found that 120 cases (84. 50%) were caused by 5 gynecologic factors, 6 cases (4. 23 %) were caused by metal factor, 16 cases(11. 27%) were caused by unknawn factor. Laparoscopy found that 130 cases (91. 55 % ) were caused by 8 gynecological factors, 5 cases (3. 52%) were caused by 3 surgical factors, 2 cases (1. 41 % ) were caused by metal factor, 5 cases (3. 52%) were caused by unknown factor. Laparoscopy revealed that chronic pelvic inflammatory disease (40- 14% ) and endometriosis (32. 39 % ) were the most common cause: the error in clinical diagnosis on the two diseases was respectively 28. 57 % and 30. 30% 3 the error between them was 19. 12 %; the error on traumatic laceration of uterine support and non-gynecological factors was 100%. The above indicated that eticology of chronic pelvic pain is complex; the error in etiologic diagnosis by preoperative pelvic examination alone is very high ; laparoscopy is an extremely valuable means for giving the definitive diagnosis on etiology of chronic pelvic pain.