腹腔镜子宫骶神经切断术治疗子宫内膜异位症疼痛的安全性和有效性观察

Safety and efficacy of laparoscopic uterine sacral neurectomy on endometriosis pain

目的:观察腹腔镜下子宫骶神经切断术(LUNA)治疗子宫内膜异位症疼痛的临床效果,并对其安全性和有效性进行评价。方法:以本院2010年1月至2014年5月期间收治的134例子宫内膜异位症伴疼痛患者为研究对象,将134例患者按随机数原则分为对照组和观察组各67例。两组患者均行病灶切除术,此外观察组在此基础加做LUNA。比较两组患者的手术情况及术后疼痛缓急情况。结果:观察组手术时间为(78.09±12.03)min,高于对照组(47.41±11.84)min,差异具统计学意义(P<0.05);术中出血量、术后肛门排气时间、住院时间、住院费用等指标两组患者间未见显著性差异(P>0.05)。术前两组患者疼痛评分无显著差异(P>0.05),术后两组患者均有所降低,疼痛症状得到缓解,组间比较结果显示,观察组疼痛评分显著低于对照组(P<0.05),同时缓解率高于对照组(P<0.05)。术后对照组患者未出现手术相关并发症;观察组有1例患者出现大便干结,排便习惯改变,经对症治疗后痊愈。结论:采用腹腔镜子宫骶神经切断术治疗子宫内膜异位症疼痛是安全且有效的,值得在临床进行推广。

Objectives：To observe the clinical effect of laparoscopic uterine sacral neurectomy on endome-triosis pain,and to evaluate its safety and efficacy.Methods：134 patients with endometriosis and pain in our hospi-tal from January 2010 to May 2014 were selected and randomly divided into control group and observation group,with 67 cases in each group.Two groups of patients were given lesions resection,while the observation group was given LUNA on this basis.Postoperative pain of the two groups was compared.Results：Operation time of the observation group was （78.09 ±12.03）min,which was higher than that of control group （47.41 ±11.84）min.The difference was statistically significant （P 〈0.05）;There were no significant difference （P 〉0.05）between blood loss,postoper-ative anal exhaust time,hospital stay,hospital costs and other indicators of the two groups of patients.There was nonbsp;significant difference in pain of the two groups before operation （P 〉0.05）.After operation,the pain of two groups of were decreased and alleviated.Comparison of the two groups showed that the observation group’s pain scores were sig-nificantly lower than that of the control group （P 〈0.05）,while the remission rate was higher （P 〈0.05）.There was no surgery related complications in patients in the control group;there was 1 patient in the observation group who had dry stool and change in bowel habits which were cured after treatment.Conclusions：Laparoscopic uterine sacral neu-rectomy on endometriosis pain treatment is safe and effective,which is worth clinical promotion.