腹腔镜术对女性绝育术后盆腔静脉淤血症诊断的价值

Preliminary study on the diagnostic value of laparoscopy in pelvic venous congestion after female sterilization.

１９９０年６月至１９９５年５月，对女性绝育术后慢性腹痛患者经腹腔镜诊断为盆腔静脉淤血症４６例，检查后施行盆腔静脉造影３２例。手术３７例次，其中经盆腔静脉造影２４例，腹腔镜检查后直接手术１３例。通过腹腔镜检查，观察盆腔静脉血管显露、曲张或怒张等形态学改变及其范围，并且根据患者由平卧位改变成头低臀高６０°位，拨动举宫器使子宫变成前屈位，计算盆腔静脉血流消失时间，拟订了女性绝育术后盆腔静脉淤血症腹腔镜下诊断标准。按此标准与盆腔静脉造影诊断标准作比较，两者无显著性差异（Ｐ＞００５），与手术中盆腔静脉血管表现和术后病理检查均相符合，证明腹腔镜术是可以作为诊断盆腔静脉淤血症的客观依据之一。

Objective:To study the diagnostic value of laparoscopy in venous congestion after female sterilization.Methods:From June,1990 to May,1995,46 patients with chronic abdominal pain were diagnosed to be pelvic venous congestion by laparoscopy and 32 cases of pelvic venography were made after examination.Of the 37 operations performed,24 cases were pelvic venography and 13 cases were direct operation after examination.Under laparoscopy,the physical outlook and scope of the pelvic veins were observed,and by changing patients’ body position or the position of their uterus,the time that blood vanished in pelvic veins was counted to set the diagnostic criterion of laparoscopy in pelvic venous congestion after female sterilization.No striking difference was found between this criterion and that of pelvic venography(P<0 05),and the outlook of the pelvic veins in the operations geared to pathological results.Conclusions:Laparoscopy examination can be used as one of the objective criterion in diagnosis of pelvic venous congestion.