盆腔子宫内膜异位囊肿与疼痛及不孕的关系

Correlation of pelvic endometriosis cysts with pain and infertility

目的探讨盆腔子宫内膜异位囊肿患者病灶根据美国生育学会修订的子宫内膜异位症分期标准（r-AFS）分期与疼痛及不孕的关系。方法回顾性分析2007年1月至2013年12月在我院行腹腔镜手术的258例子宫内膜异位囊肿的患者的临床资料。同时根据r-AFS分期情况评价盆腔子宫内膜异位症囊肿盆腔病灶与疼痛及不孕的关系。结果258例子宫内膜异位囊肿患者中伴有疼痛72．09％（186／258），不孕16．28％（42／258）。r-AFS分期：Ⅰ期16例，Ⅱ期80例，Ⅲ期108例，Ⅳ期54例。186例疼痛患者中Ⅲ、Ⅳ期病例占77．42％（144／186），与72例无症状患者中Ⅲ、Ⅳ期病例25．00％（18／72）比较，差异有统计学意义（χ^2=64．017，P〈0．05）。42例不孕患者中Ⅲ、Ⅳ期病例占85．71％（36／42），与216例可孕患者中Ⅲ、Ⅳ期病例58．33％（126／216）比较，差异有统计学意义（χ^2=11．283，P〈0．05）。结论盆腔子宫内膜异位囊肿盆腔病灶r-AFS分期与盆腔子宫内膜异位症疼痛及不孕有关，Ⅲ、Ⅳ期患者发生疼痛，不孕的比例高。

Objective To study the correlations of pelvic endometfiosis cysts with pain and infertility according to the revised American Fertility Society （r-AFS） staging of endometriosis. Methods We retrospectively studied the clinical information of 258 cases patients with the ovarian endometriosis cysts who undergoing laparoscopic ovarian endometriosis cysts excision from January 2007 to December 2013. In accordance with the r-AFS ,the correlation between pelvic adhesions and pain symptoms or infertility was evaluated. Results Among 258 cases with ovarian endometriosis cysts, there were 72. 09% （ 186/258 ） of patients presented pelvic pain and 16.28% of patients presented infertility. The stages of r-AFS were that 16 cases in stage 1,80 cases in stage II,108 cases of in stage III and 54 cases of stage IV. Also,186 cases with pain symptom,77.42% （144/186） of patients were in stage III and IV,which was remarkably higher than that of no symptom group （25.00%（ 18/72）, χ^2= 64. 017, P〈0. 05）. Among 42 cases with infertility, there were 85.71% （36/42） of patients were in stage III and IV, remarkably higher than of no infertility group （58. 33% （126/216）, X2 = 11. 283 ,P〈 O. 05 ）. Conclusion The r-AFS stage of pelvic distribution in ovarian endometriosis cyst is closely correlated with pain symptoms and infertility. Patients in stage III and IV with pain and infertility are more significant.