超声刀在腹腔镜手术治疗子宫内膜异位症中的效果评价

Clinical application of ultrasonic scalpel in the laparoscopic surgery to treat endometriosis

目的评估超声刀在腹腔镜手术治疗子宫内膜异位症的效果。方法随机将247例子宫内膜异位症患者分为超声刀腹腔镜组与单纯腹腔镜组,对比分析两组的手术情况、症状改善情况、术后并发症、术后复发率和自然妊娠率。结果超声刀腹腔镜组在手术时间、出血量、术后发热、胃肠功能恢复等指标均显著优于单纯腹腔镜组。超声刀腹腔镜组的术后痛经改善率明显高于单纯腹腔镜组(72.1%vs.35.9%,P<0.01);术后复发率明显低于单纯腹腔镜组(4.1%vs.18.5%,P<0.01);术后妊娠率明显高于单纯腹腔镜组(61.1%vs.34.2%,P<0.01)。结论超声刀腹腔镜手术治疗各期子宫内膜异位症具有微创、出血少、恢复快,术后并发症少等优势,且与单纯腹腔镜手术结果比较,术后妊娠率明显增加,值得临床推广。

Objective To evaluate the advantages and effect of using ultrasonic scalpel in the laparoscopic surgery to treat endometriosis. Methods 247 patients with endometriosis were randomly divide into two groups,one treated with ultrasonic scalpel laparoscope,and the other with pure laparoscope （ control group） . The operation situation,improvements of symptoms,postoperative complications,postoperative recurrence rate and postoperative spontaneous pregnancy rate were compared. Results The group with ultrasonic scalpel laparoscope treatment had better result in terms of operation duration,intraoperative blood loss,postoperative pyrexia,gastrointestinal functional recovery comparing to the control group. The group with ultrasonic scalpel laparoscope treatment had much better improvements in postoperative dysmenorrhea （ 72. 1% vs. 35. 9% ,P 0. 01） ; and had better postoperative recurrence rate（ 4. 1% vs. 18. 5% ,P 0. 01） ; also had much better postoperative spontaneous pregnancy rate. Conclusions Using ultrasonic scalpel in the laparoscopic surgery has the advantages of minimally invasive,less bleeding,quicker recovery and less postoperative complications in the treatment of endometriosis of different stages. Plus,comparing to the control group,it has better postoperative spontaneous pregnancy rate and applicable in the clinical treatment.