妇科再次腹腔镜术的探讨──附36例临床分析

Preliminary clinical research of secondary laparosocopy in gynecology: with 36 cases analysis

目的；探讨妇科再次腹腔镜术的指征、手术时机、处理方法及价值。方法：回顾性分析因妇科疾病行再次腹腔镜术的３６例病人的临床资料。结果：再次腹腔镜术与首次腹腔镜术间隔时间３个月至６０个月，中位间隔时间为 ２５个月。 １８例（５０％）的再次腹腔镜术指征与首次相同，其中不孕症 １４例（原发不孕９例，继发不孕 ５例），盆腔色块 ３例，继发性痛经１例。手术指征不一致的１８例中，不孕症３例，盆腔色块４例，绝育１例，异位妊娠 ６例，配子输卵管移植 ４例。再次腹腔镜术完成镜下手术治疗 ３２例，占８９％，镜下治疗人数较首次腹腔镜术多（Ｐ＜０．０１），疗效满意。结论：再次腹腔镜术手术指征与首次相比有所不同，手术时机依不同情况而异；再次腹腔镜术与首次腹腔镜术一样，对妇科疾病具有较高的诊断和治疗价值。

Objective: To investigate the indications, time and management of secondary laparoscopy in gynecology. Methods: Thirty-six patients with gynecological diseases undergoing seconday laparoscopy were analyzed retrospectively. Results: The interval between the first and secondary laparoscopy ranged from 3 months to 60 months, the median interval was 25 months. The indications for secondary laparoscopy were the same as the first laparoscopy in 18 cases (50%). Infertility was also the first indication for secondary laparescopy. Thirty-two cases (89 %) nuderwent surgery during secondary laparoscopy. More Patients underwent surgery in secondary laparoscopy than first laparascopy (P<0.01) and the outcomes were satisfactory. Conclusions: The indications for secondary laparoscopy are somewhat different from first laparoscopy and the time for secondary laparoscopy depends on the patients' condition. Secondary laparoscopy have the same value in diagnosis and treatment as the first laparoscopy when the indications and time for surgery are appropriate.