腹腔镜下宫骶韧带切断术联合病灶剥除电灼术治疗子宫内膜异位症痛经的临床效果

目的探讨腹腔镜宫骶韧带切断术联合病灶剥除电灼术治疗子宫内膜异位症所致痛经的疗效. 方法 2000年3月～2004年8月对86例子宫内膜异位症所致痛经行腹腔镜下宫骶韧带切断术联合病灶剥除电灼术,对其中37例同时行卵巢子宫内膜异位囊肿剥除与盆腔子宫内膜异位病灶电灼术,余49例同时对肉眼所见盆腔子宫内膜异位病灶予以电灼.3例因宫骶韧带增粗或局部粘连,术中在插入输尿管红外线显示导管后予以切断. 结果 86例随访6～48个月,中位时间23个月,痛经完全缓解36例,部分缓解29例,21例无效,有效率75.6%(65/86). 结论腹腔镜下宫骶韧带切断术联合病灶剥除电灼术对子宫内膜异位症所致痛经治疗效果显著.

On clinical effects of uterosacral ligament amputation in combination with lesion electrofulguration under laparoscope for endometriosis-related dysmenorrhea

Objective To evaluate the efficacy of uterosacral ligament amputation in combination with lesion electrofulguration under laparoscope in the treatment of endometriosis-related dysmenorrhea. Methods A total of 86 patients with endometriosis-related dysmenorrhea were treated by uterosacral ligament amputation combined with electrofulguration of lesions under laparoscope from March 2000 to August 2004 in this hospital. Among the 86 patients, enucleation of ovarian endometriotic cysts and electrofulguration of pelvic endometriotic lesions were also simultaneously conducted in 37 patients, and electrofulguration of all visible pelvic endometriotic lesions was also performed in the rest of 49 patients. The operation was accomplished with the aid of the placement of an infrared ureteral detector in 3 patients because of the thickening of the uterosacral ligament and local adhesion. Results The 86 patients were followed for 6~48 months (median, 23 months). Dysmenorrheal completely disappeared in 36 patients, partially subsided in 29, and remained unchanged in 21, the effective rate being 75.6% (65/86). Conclusions Uterosacral ligament amputation combined with electrofulguration of lesions under laparoscope is effective for the treatment of endometriosis-related dysmenorrhea.