不同手术方式在重型子宫内膜异位症中的应用比较

目的：探讨腹腔镜保守手术与根治性手术在重型子宫内膜异位症中的可行性。方法统计分析2011年1月至2014年1月江苏省昆山市第一人民医院友谊分院收治的100例重型子宫内膜异位症患者的临床资料。结果根治性手术中，腹腔镜手术患者的手术时间比开腹手术患者长（t＝4．303，P＝0．033），术中出血量比开腹手术患者少（t＝3．182，P＝0．026），术后最高体温比开腹手术患者低（t＝2．776，P＝0．035），排气时间比开腹手术患者短（t＝2．571，P＝0．014），术后病率比开腹手术患者高（χ2＝9．492，P＝0．035），使用镇痛剂发生率比开腹手术患者低（χ2＝11．072，P＝0．028）。保守性手术中，腹腔镜手术患者的手术时间比开腹手术患者短（t＝2．447，P＝0．029），术中出血量比开腹手术患者少（t＝2．365，P＝0．041），术后最高体温比开腹手术患者低（t＝2．306，P＝0．037），排气时间比开腹手术患者短（t＝2．262，P＝0．016），术后病率和使用镇痛剂发生率比开腹手术患者低（χ2值分别为9．352、5．991，均P＜0．05）。结论腹腔镜手术疗效优于开腹手术，尤其是在保守手术中，其在重型子宫内膜异位症中安全可行。

Application of different surgeries in the treatment of severe endometriosis

Objective To investigate the feasibility of laparoscopic conservative surgery and radical surgery in the treatment of severe endometriosis.Methods Statistical analysis was made on the clinical data of 100 cases of severe endometriosis in Friendship Branch Hospital of First People’s Hospital of Kunshan from January 2011 to January 2014.Results Compared with open surgery, the surgical time of laparoscopic surgery was significantly longer （t=4.303, P=0.033）, the blood loss was significantly less （t=3.182, P=0.026）, the highest temperature was significantly lower （t=2.776,P=0.035）, the exhaust time was significantly shorter （t=2.571, P=0.014）, the postoperative morbidity was significantly higher （χ2 =9.492,P=0.035） , the use of analgesics was significantly lower （χ2 =11.072, P=0.028） in radical surgery.But in conservative surgery, the operative time of laparoscopic surgery was significantly shorter （ t=2.447, P=0.029）, the bleeding was significantly less （t=2.365,P=0.041）, the highest temperature was significantly lower （t=2.306,P=0.037）, the exhaust time was significantly shorter （t=2.262,P=0.016）, the postoperative morbidity and the use of analgesics were significantly lower than those of open surgery （χ2 value was 9.352 and 5.991, respectively, both P〈0.05）.Conclusion The effect of laparoscopic surgery is superior to open surgery, especially in conservative surgery.It is safe and feasible in the treatment of severe endometriosis.