腹腔镜不同术式治疗卵巢子宫内膜异位囊肿的临床观察

目的:探讨腹腔镜不同术式治疗卵巢子宫内膜异位囊肿的手术疗效。方法:回顾性分析2013年1月至2015年8月杭州市第一人民医院、杭州市妇产科医院采用腹腔镜治疗卵巢子宫内膜异位囊肿患者95例的临床资料,根据术式分为凝固术组(45例)和囊肿剥除组(50例),术后对两组患者进行12个月的随访,比较两组患者术后卵巢子宫内膜异位囊肿及相关疼痛复发、术后血清促卵泡生成素(FSH)值和卵泡计数等差异。结果:术后两组均随访12个月,囊肿剥除组卵巢子宫内膜异位囊肿复发率、卵巢子宫内膜异位囊肿相关疼痛复发率均明显低于凝固术组(P0.05)。术后6个月及12个月,囊肿剥除组卵泡计数均明显多于凝固术组(P0.05),而两组FSH水平无显著差异。结论:与腹腔镜卵巢子宫内膜异位囊肿凝固术比较,腹腔镜囊肿剥除术能更有效降低痛经、性交痛、非经期盆腔痛等相关疼痛及子宫内膜异位症病灶的复发,并在术后卵巢储备功能方面更具优势。

Clinical observation of laparoscopic surgery in the treatment of ovarian endometriosis cyst

Objectives:To evaluate the curative effect of laparoscopic surgery in the treatment of ovarian endometriosis cyst.Methods:The clinical data of 95 patients with ovarian endometriosis cyst from January 2013 to August 2015 were analyzed.All the patients were divided into coagulation group (45 cases) and cystectomy group (50 cases) according to surgery methods.After 12 months of follow-up,the recurrence of ovarian endometrial cysts and associated pain,postoperative serum follicle stimulating hormone (FSH) and follicle count between the two groups were compared.Results:In the postoperative 12 months' follow-up,the recurrence rates of ovarian endometriosis cyst and ovarian endometriosis associated pain in cystectomy group were significantly lower than those in the coagulation group (P ＜ 0.05).After 6 ～ 12 months,follicle count in patients of cystectomy group were significantly more than patients of coagulation group (t =6.42,5.39,P ＜ 0.05),and the difference in serum FSH values between the two groups was not statistically significant (P ＞ 0.05).Conclusion:Compared with laparoscopic ovarian endometriosis cyst coagulation,laparoscopic cyst stripping resection could relieve dysmenorrhea,dyspareunia,non-menstrual pelvic pain more effectively,and reduce the recurrence of endometriosis lesions,which has more advantages in terms of the postoperative ovarian reserve function.