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Objective To investigate the relationship between degree of endometrioma adhesions and clinical feature, surgical treatment and postoperative recurrence. Methods From Jan 2003 to Mar 2008, 662 patients with endometrioma undergoing laparoscopic ovarian endometrioma excision in Peking Union Medical College Hospital were studied retrospectively. All patients were classified into four groups according to the extent of adhesions: 31 cases in none adhesions group, 123 cases in mild adhesions group (filmy thickness, avascular, easily separated adhesions), 310 cases in moderate adhesions group (less than a half of ovary was adjacent to dense thickness adhesions which was difficult to separate, or above a half of ovary were adjacent to filmy thickness adhesions) and 198 cases in severe adhesions group (above a half of ovary was adjacent to dense thickness, well vascularized adhesions which was difficult to separate, and always involved the other pelvic organs, observed angiogenesis). The comparison of degree, characteristics, period of pain, lab test, surgical management and postoperative recurrence was performed among those above groups. In the mean time, risk factors and multinomial logistic regression were analyzed. Results (1)Clinical characteristics: The incidence of patients with dysmenorrhea, dyspareunia, straining feeling in anus, chronic pelvic pain and the level of CA125 (>35 kU/L) was remarkably higher in moderate-to-severe adhesion groups than in none-to-mild adhesions groups (P=0.000, 0.000, 0.001, 0.006 and 0.000, respectively). Infertility rate were significantly higher in severe adhesions group(15.7%,31/198) than none adhesions group(3.2%,1/31), mild adhesions group(11.4%,14/123) and moderate adhesions group(9.7%,30/310, OR=1.728, P<0.05).(2)Operating time and blood loss: Operating time of each groups was as followed: (37±15) min in none adhesions group, (42±19) min in mild adhesions group, (50±20) min in moderate adhesions group and (63±22) min in severe adhesion group. Blood loss was (23±12) ml in none adhesion group, (31±27) ml in mild adhesion group, (40±32) ml in moderate adhesion group and (70±67) ml in severe adhesions group. Thicker adhesions result in longer operation time and more blood loss. (3)Combined with other disease: The ratio of patients who combined with adenomyosis or deeply infiltrating endometriosis in moderate-to-severer adhesion groups was higher than patients in none-to-mild adhesions groups (OR=3.466, P=0.000). (4) Postoperative recurrence: It was categorized into recurrence of pain and cyst. Moderate-to-severe adhesions was related to higher recurrence rate of pain (OR=1.685,P=0.046), but was irrelevant to recurrence of cyst. Conclusion The more extent of endometrioma adhesions was related to severer pelvic pain symptoms, longer operating time and more blood loss. Postoperative pain recurrence rate was observed in moderate-to-severe adhesion group. Extent of adhesions was irrelevant to cyst recurrence. 相似文献
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对多数患者来说,外科手术是一种强烈的心理事件,这一方面是因为手术可以解除疾病对病人的折磨,因而怀有强烈的期待心理;另一方面手术也可以带来某些暂时的痛苦。甚至可能发生某种合并症或意外。 相似文献
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近年来,腹腔镜下胆囊切除术由于其低侵袭性巳在欧美及日本等先进国家迅速普及,成为胆囊良性疾病治疗的第一选择。但由于在腹腔镜下操作的特殊性,时有各种并发症出现,尤其在处理有炎症粘连或肥胖患者的Calot三角部时,容易损伤胆管或其它脏器导致严重后果。最近,我们应用超声吸引装置(CUSA)对3例胆囊结石患者做了腹腔镜下胆囊切除术,发现其在管道结构的显露上有独特优点,现报告如下: 相似文献
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对温州蜜橘所含的橙皮苷(Hsp),用环糊精合成酶使之附加葡萄糖,形成橙皮苷葡糖苷(Hsp—G),从而使水溶性明显增强。曾报道,经口给予柑橘类黄酮Hsp后,可以减轻胶原诱发关节炎(CIA)的病情。此次,对Hsp—G单独给予以及与Hsp联合给予对CIA发病的影响进行了探讨。 相似文献
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目前,脑卒中和心肌梗塞的“Heart Attack”一样在发病后应立即采取急救措施,做为“Brain Attack”其重要性被再次认识。在美国,开展了“Stroke is a emergen-cy”的Brain Attack宣传活动,为强调早期就诊、早期治疗的必要性,列举了以下5条脑卒中的症状①急性半身无力、瘫痪;②急性语言障碍、意识障碍;③急性视力障碍;④急性眩晕、走路摇晃,步行障碍;⑤突发的剧烈头痛。 相似文献
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