腹腔镜治疗深部浸润型子宫内膜异位症临床疗效61例分析

Laparoscopic treatment of deeply infiltrating endometriosis:clinical analysis of 61 cases

目的探讨腹腔镜手术治疗深部浸润型子宫内膜异位症的疗效和安全性。方法对北京大学第一医院收治的61例深部浸润型子宫内膜异位症患者临床资料进行分析。结果 61例手术均在腹腔镜下完成,无严重手术并发症。随访55例(随访率90.2%),平均随访时间42.7个月(12～74个月)。术后痛经缓解率分别为1年53.1%、2年51.1%、3年66.7%,与术前相比较差异均有统计学意义(P<0.001)。但非经期下腹痛、肛门或直肠痛和性交痛与术前相比,差异无统计学意义。29例有生育要求者13例妊娠(44.8%);其中8例合并不孕症者4例妊娠(50%)。结论腹腔镜治疗深部浸润型子宫内膜异位症安全有效。

Objective To analyze the curative effect and safety of laparoscopic excision of deeply infiltrating endometriosis.Methods The data of 61 cases with deeply infiltrating endometriosis in our hospital were analyzed retrospectively.Results All patients were treated successfully by laparoscopic surgery with no serious complications.Fifty-five cases（90.2%）were followed up with 12～74 months（median 42.7 months）.Rate of dysmenorrhea remission in one,two and three years after surgery were 53.1%,51.1% and 66.7%,respectively（P0.001）.There were no significant differences in the remission rate of non-cyclic pelvic pain,deep dyspareunia and anal or rectal pain.Thirteen patients had fertility requirement（44.8%）.Four of the 8 patients with infertility got pregnant after surgery（50%）.Conclusions Laparoscopic excision of deeply infiltrating endometriosis is effective and safe.