摘要
目的探讨复发性盆腔子宫内膜异位症（RPEM）再次手术治疗的效果。方法2005年4月至2010年lO月我院妇科收治RPEM患者47例，均行再次手术治疗，分析其疗效，并与首次手术资料进行对比分析。结果再次手术组痛性结节28例，首次手术组14例，差异有统计学意义（Х^2=8．436，P=0．004）；再次手术组行腹腔镜手术25例，首次手术组40例，差异有统计学意义（Х^2=7．259。P=0．007）；再次手术组手术时间（106．4±41．0）min、术中出血量（143．2±118．3）ml，首次手术组分别为（78．4±26．4）min、（70．6±68．1）ml，差异均有统计学意义（t值分别为3．995、3．660，P均〈0．01）。结论RPEM粘连广泛而且致密，再次手术应小心分离粘连，注意周围解剖关系，且尽量恢复盆腔器官正常解剖及生理状态，减少术后粘连。术中彻底清除病灶是提高疗效及预防复发和再次手术的关键。
Objective To explore the effects of reoperation on treatment of recurrent pelvic endometriosis （RPEM）. Methods The clinical data of 47 cases of RPEM reoperation in our hospital from April 2005 to October 2010 was investigated, and the efficacy was analyzed compared with the first operation data. Results The cases of painful nodules was significantly different between reoperation group and the first operation group（28 vs 14, Х^2 = 8. 436, P = 0. 004）. There was significant difference on laparoscopic surgery cases between reoperation group and the first operation group （25 vs 40, Х^2 = 7.259, P = 0. 007 ）. The operation time in reoperation group was significantly longer than that in the first operation group （[ 106.4± 41. 0 ] min vs [ 78.4± 26.4 ] min, t = 3. 995, P 〈 0.01 ）, and the amout of intraoperative hemorrhage in reoperation group was more than that in the first operation group （ [ 143.2 ±118. 3 ] ml vs [ 70.6 ±68. 1 ] ml, t = 3. 660, P 〈 0.01 ） . However,there was no significant difference on symptoms, cyst location and clinical stage between these two groups（P 〉 0. 05）. Conclusion Due to the pelvic adhesion would be dense and extensive in RPEM, it should be carefully dissected during reoperation. At the same time, the operator should pay attention to the anatomical location and try to restore the normal anatomy of the pelvic organs and physiological state, and try to reduce postoperative adhesions. Complete removal of the lesions is the key to improve the treatment effect and prevent recurrence and reoperation.
出处
《中国综合临床》
2012年第6期666-668,共3页
Clinical Medicine of China
