两种不同术式治疗卵巢子宫内膜异位囊肿合并不孕患者的临床疗效观察

Clinical efficacy of two surgical options for treatment of ovarian endometrial cysts complicated with infertility

目的:研究腹腔镜治疗卵巢子宫内膜异位囊肿合并不孕患者的临床疗效。方法:选取2008年1月-2010年1月在本院本科室90个卵巢子宫内膜异位囊肿并不孕的患者,根据手术方式分为腹腔镜组(46例)及开腹组(44例)。比较两组患者手术时间长短,术中出血量,肛门排气时间及住院时间,评价两组患者临床症状缓解情况及术后18月患者的妊娠率及复发率。结果:腹腔镜组手术时间、出血量、肛门排气时间及住院天数均少于开腹组(P<0.05),而术后总妊娠率为47.83%高于开腹组的29.55%(P<0.05),同时三大临床症状的缓解率及复发率与开腹组间无统计学差异(P>0.05)。结论:对于卵巢子宫内膜异位囊肿患者,腹腔镜手术可达到与开腹手术相同治疗效果,且具有微创,术后恢复快的特点,并且可获得高于开腹手术的术后妊娠率。

Objective： To study the clinical efficacy of laparoscopic surgery for treatment of ovarian endometrial cysts complicated with infertility. Methods ：90 infertile cases with ovarian endometrial cysts betweeen January 2008 and January 2010 in our department were included in the study and divided into two groups： laparoscopic group （n = 46 ） and open laparotomy group （n = 44 ）. We compared the operation duration, blood loss ,time to recovery of bowel function and length of hospital stay between groups, and also evaluated the resolution of clinical symptoms, as well as 18-month rates of pregnancy and recurrence in the both groups. Results：Shorter operation duration, less blood loss, quicker recovery of bowel function and fewer hospital days were noted in laparoscopic group compared with open laparotomy group （P 〈 0.05 ）. The overall pregnancy rate in laparoscopic group （47.83%） was higher than that in open laparotomy group （29.55%）. There were no significant difference betweens in resolution of three major symptoms and in disease recurrence between the two groups （ P 〉 0.05 ）. Conclusion ： For ovarian endometrial cyst complicated with infertility, laparoscopic surgery is as effective as open surgery, and also provides additional benefits in terms of mini-invasiveness, quicker recovery and higher post-surgical rate of pregnancy than does the open surgery.