腹腔镜诊断和治疗子宫内膜异位症及不孕症的临床疗效研究

Clinical Efficacy of Laparoscopic Diagnosis and Treatment of Endometriosis and Infertility

目的对腹腔镜诊断和治疗子宫内膜异位症及不孕症的临床疗效研究进行分析。方法选取2015年3月~2016年11月郑州市妇幼保健院收治的152例子宫内膜异位症及不孕症患者作为本次研究对象,本组患者分别采用腹腔镜以及病理检查进行诊断,在腹腔镜下进行治疗,并且术后采用促性腺激素释放激素激动剂对患者进行4个月的治疗。对患者诊断情况、腹腔镜手术情况、术后临床疗效以及妊娠情况进行分析。结果对子宫内膜异位症及不孕症运用腹腔镜进行诊断,包括宫骶韧带71.71%、子宫表面13.82%、阔韧带61.18%,检查病灶数高于病理检查结果,差异有统计学意义(P<0.05)。在治疗中,患者治疗效果显著,无中转开腹病例,无并发症出现。原发性不孕有效率达94.03%,继发性不孕有效率达92.94%,术后原发性不孕总妊娠率达80.60%,继发性总妊娠率达88.24%。结论腹腔镜诊断和治疗子宫内膜异位症及不孕症,诊断方式准确,效果良好,治疗后复发率低,临床效果显著。

Objective To analyze the clinical efficacy of laparoscopic diagnosis and treatment of endometriosis and infertility. Methods A total of 152 patients with endometriosis and infertility admitted to Zhengzhou Maternal and Child Health Hospital from March 2015 to November 2016 were enrolled. The patients were diagnosed by laparoscopy and pathological examination. The treatment was performed under laparoscopy and the patient was treated with a gonadotropin-releasing hormone agonist for 4 months. The patient＇s diagnosis, laparoscopic surgery, postoperative clinical efficacy, and pregnancy were analyzed. Results Laparoscopy was used to diagnose endometriosis and infertility, including 71.71% of uterine ligament, 13.82% of uterine surface and 61.18% of broad ligament. The number of lesions was higher than that of pathological examination with statistically significant（P〈0.05）. The patient＇s treatment effect was significant, without conversion to open surgery and any complication. The effective rate of treatment for primary infertility was 94.03%, the effective rate of treatment for secondary infertility was 92.94%, the total pregnancy rate of treatment for postoperative primary infertility was 80.60%, and the secondary total pregnancy rate of treatment for was 88.24%. Conclusion Laparoscopic diagnosis and treatment of endometriosis and infertility have accurate diagnosis and good effect. The recurrence rate is low after treatment and the clinical effect is significant.