腹腔镜在卵巢子宫内膜异位囊肿合并不孕症诊治中的应用价值

Practice of Treatment of Ovarian Endometrial Cyst with Female Infertility by Laparoscopy

目的：评价腹腔镜在治疗卵巢子宫内膜异位囊肿合并不孕症（简称卵巢子宫内异囊肿并不孕）中的价值。方法：选择98例卵巢子宫内异囊肿并不孕的病例,均行卵巢子宫内膜异位囊肿剥出术,56例在腹腔镜下进行（腹腔镜组）,42例进行传统开腹手术（开腹组）。两组术后均服用孕三烯酮3-6个月。分别比较两组患者的手术时间,术中出血量和住院天数,同时随访术后妊娠率和复发率。结果：腹腔镜组手术平均时间（48.5 min）短于开腹组（71.3min）,腹腔镜组术中出血量（54.6 mL）少于开腹组（118.5 mL）,其平均住院天数（4.2 d）也少于开腹组（7.6 d）,腹腔镜组术后妊娠率为40.4%高于开腹组（20.0%）。两组比较均有显著性意义。随访1年腹腔镜组复发率为9.61%,开腹组为10.0%,两组比较差异无显著性意义。结论：对于卵巢子宫内异囊肿并不孕患者,在腹腔镜下行囊肿剥出术,具有出血少,手术时间短,住院天数短等优越性,术后及时助孕治疗的效果较传统开腹手术好。

Objective：To evaluate the clinical effect of Ovarian endometrial cysteclomy with laparotomy or laparoscopic operation. Methods：98 cases of ovarian endometrial cyst with infertility underwent two approaches by which 56 cases received operation, and 52 cases received laparotomy. The patients took gestrinone for 3-6 months after operation in two groups. The operative duration, blood loss, hospital day,recurrence and pregnancy rate with two approaches were retrospectively reviewed and compared. Results：Compared with the other group, the patients who received laparoscopic cysteclomy had shorter operative duration（48.5 min vs 71.3 min）, less blood loss（54. 6 mL vs 118. 5 mL）, shorter hospitalization （4.2 d vs 7.6 d）, higher pregnancy rate（40.4 % vs 20.0 %）, the differences were significant. The differences of racurrences in 1 year were no significant in two groups（9.61 % vs 10.0%）. Conclusion：Laparoscopic cysteclomy has more advantage in treatment of ovarian endometrial cyst with infertility over laparotomy, for example lower hemorrhage, shorter operation time and hospital day, better assist reproduction effect post operation.