腹腔镜配合药物治疗子宫内膜异位症效果分析

Laparoscopic combined with drug for chronic pelvic pain induced by endometriosis

目的探讨子宫内膜异位症所致盆腔疼痛的手术治疗方案及腹腔镜术后辅助药物治疗降低复发率的效果。方法回顾性收集147例以盆腔疼痛为主要症状的子宫内膜异位症患者,比较分析腹腔镜及经腹手术术后疼痛的缓解率及单纯腹腔镜手术与术后辅助药物治疗远期疼痛的复发情况。结果腹腔镜手术与经腹手术治疗后疼痛的缓解率为77.36%、75.56%,两组患者术后疼痛缓解率及复发率差异无显著性(P>0.05)。经观察及随访2年,腹腔镜术后加药物组复发率明显低于单纯腹腔镜手术组,差异有显著性(P<0.05)。结论腹腔镜手术可作为以盆腔疼痛为主要症状的子宫内膜异位症患者的首选治疗,术后辅助药物治疗可明显降低疼痛的复发率。

[ Objective ] To discuss the treatment of the chronic pelvic pain induced by endometriosis. To ob- serve the efficacy of laparoscopy combined with GnRH-a in reducing the recurrence rate. [ Methods ] The relieving situations of pelvic pain about 147 endometfiosis patients were analyzed retrospectively . The pelvic pain relieving rate of patients with different surgical modalities and the recurrence rate of patients retreated by laparoscopy com- bined with GnRH-a with the others were compared. [ Results ] The relieving rate of pelvic pain was 77.36% and 75.56% in the groups of laparoscopic surgery alone and transabdorminal surgery alone. There was no significant dif- ference in two groups （P 〉0.05）. Patients were followed up for 2 year. The recurrence rate of patients retreated by la- paroscopy combined with GnRH-a was reduced significantly（P 〈0.05）. [ Conclusion ] Laparoseopy treatment is effec- tive for the pelvic pain induced by endometriosis, and post operative drug therapy can induce the recurrence rate ev- idently.