应用腹腔镜诊断和治疗子宫内膜异位症及不孕症的疗效

Clinical study of effect of laparoscopic diagnosis and treatment on pelvic endometriosis-associated infertility

目的:观察分析腹腔镜诊断和治疗子宫内膜异位症及不孕症的效果。方法:选台安县恩良医院经病理检查证实为EMT的患者112例,在腹腔镜检查的同时进行手术治疗:对于腹膜表浅的病灶,采用电凝或烧灼治疗;深部浸润型病灶,进行连续烧灼破坏或切除。粘连部位按分离、剥除、止血和预防粘连步骤进行切除。将诊断、治疗结果数据进行统计分析。结果:腹腔镜检测的阳性率为93.1%,敏感度为89.2%,特异度为89.2%;腹腔镜下共诊断出405个病灶数,病理共诊断323个病灶数;腹腔镜与病理诊断总的符合率比较,差异有统计学意义(P<0.05)。腹腔镜手术治疗患者全部治愈,手术后,妊娠88例,Ⅰ期12例,85.71%,Ⅱ期45例,81.82%,Ⅲ期23例,74.19%,Ⅳ期14例,66.67%,总受孕率为78.57%。各期妊娠率差异具有显著差异。结论:腹腔镜诊断子宫内膜异位症准确、高效,治疗子宫内膜异位及不孕症效果明显,复发率低,是诊断和治疗子宫内膜异位和不孕的首选。

Objective：To investigate the role of laparoscopy in diagnosis and treatment of infertile women with endometriosis.Methods：We selected 112 cases of EMTpatients confirmed by enliang hospital through pathological examination.We took an Operation when we had laparoscopy.We used electric coagulation or cauterization to treat the peritoneal of superficial lesions.For deep infiltrative lesions,we conducted a continuous burning damage or resection.Adhesion sites were removed by separation,peeling,hemostasis and prevention of adhesion steps.We made statistical analysis for the diagnosis and treatment data.Results：The positive rate of laparoscopic detection was 93.1%,the sensitivity was 89.2%,specificity was 89.2%.we diagnosed 405 lesions by laparoscopy,and 323 lesions through pathological diagnosis.The differences of laparoscopic and pathological diagnosis coincidence rate were statistically significant（P〈0.05）.patients taken Laparoscopic operation were totally cured.After operation,88 cases were pregnant,12 cases of Ⅰ stage 85.71%,45 cases of Ⅱ stage 81.82%,23 cases of Ⅲ stage 74.19%,14cases of Ⅳ 66.67%.The total fertility rate was 78.57%.There are significant difference of pregnancy rates at different stages.Conclusions：of endometriosis is accurate,efficient.With significant effects on the treatment of endometriosis and infertility and low rate of recurrence,Laparoscopic diagnosis is the top choice for the diagnosis and treatment of endometriosis and infertility.