子宫内膜异位症微腹腔镜病患辅助疼痛定位的研究

Patient-Assisted Laparoscopy Pain Mapping on Endometriosis by Mini-laparoscopy

目的:微腹腔镜病患辅助疼痛定位确定子宫内膜异位症疼痛的好发部位,探讨疼痛病因。方法:前瞻性队列研究25例手术治疗的子宫内膜异位症患者,应用微腹腔镜检查技术在病患辅助下进行疼痛定位,记录病史、体征、辅助检查、手术情况、术中病变情况、手术病理结果。应用SPSS13.0软件分析。结果:25例经微腹腔镜证实为子宫内膜异位症的患者,子宫内膜异位症病变和疼痛的符合率为90.80%(79/87)。宫骶韧带是各种疼痛症状的好发部位,红色病变发生疼痛的机率高,盆腔粘连的牵拉痛多于触痛(P<0.05)。r-AFS分期与术前疼痛程度对病变的反映无一致性(P=0.141,kappa=0.176)。结论:微腹腔镜诊断子宫内膜异位症可以疼痛定位,宫骶韧带病变是疼痛的好发部位,红色病变出现疼痛机率大,疼痛与分期无关。

Objective：To evaluate the collection between endometriosis pain and pathological changes through Patient-Assisted Laparoscopy Pain Mapping （PALPM） of mini-laparoscopy, Methods： Prospective study is formed. Patients with endometriosis underwent patient-assisted laparoscopy pain mapping （PALPM） by mini-laparoscopy. The symptom, sign, examination, and pathological changes were registered.Results：In 25 endometriosis cases that confirmed by mini-laparoscopy, PALPM found that the accordant ratio of pain and pathological change is 90.80% （79/87）. Pathological change on sacrum ligament was predilection site for pain. There was higher probability of red lesion occurring pain. Dragged pain caused by peMc adhesion exceeded tenderness （ P〈 0.05）. r-AFS scoring systern didn＇t reflect the degree of pain （ P=0.141 ,kappa= 0.176）. Conclusions. PALPM finds that pathological changes on sacrum ligament occur more often, red pathological change arouses more pain, dragged pain occurs more often than touched pain, r-AFS system can not reflect the degree of pain.