腹腔镜手术治疗子宫内膜异位症156例临床疗效分析

目的探讨腹腔镜手术治疗子宫内膜异位症的临床疗效。方法回顾分析156例子宫内膜异位症在腹腔镜下进行诊断手术的经验。结果156例内异症患者154例通过腹腔镜成功完成手术,2例因盆腔广泛粘连、子宫多发性肌瘤合并腺肌瘤,操作困难中转开腹。62例行卵巢子宫内膜异位囊肿剥除术(单侧38例,双侧24例),异位病灶电凝或内凝术122例,同时行粘连松解术84例,输卵管造口术36例,子宫肌瘤剔除术8例,输卵管通液术94例,双侧输卵管通畅46例,单侧通畅36例,双侧阻塞12例。手术时间30～120 min,平均78min。术中出血5～50 ml,平均20 ml。均无严重并发症发生。跟踪随访120例,痛经70例中38例痛经症状消失,8例明显减轻,总有效率65.7%。94例不孕者中40例妊娠,妊娠率42.6%。结论腹腔镜手术治疗子宫内膜异位症安全、有效、利于恢复,尤其对合并不孕症患者,可明确诊断,又可同时治疗,提高妊娠率。

Analysis on clinically curative effect on endometriosis by celioscopy in 156 patients

Objective To investigate the clinically curative effect of celioscopy on endometriosis.Methods Retrospective analysis was conducted on 156 patients with endometriosis who received celioscopy.Results Of the 156 patients,154 underwent the operation by celioscopy successfully,whereas the other two were converted to open abdominal operation due to wide organ adhesion in their pelvic cavities.Ectopic cysts in endometria and ovaries were removed in 62 patients(unilateral in 38,bilateral in 24),ectopic foci were given electric or inner coagulation in 122 ones,adhesion was loosened in 84 ones,salpingostomy was performed in 36 ones,hysteromyomas were resected in 8 ones,hydrotubation was performed in 94 ones,and oviducts were dredged bilaterally in 46 and unilaterally in 36 ones,and bilaterally obstructed in 12 ones.Operation duration was 30-120 minutes(mean=78 minutes).Blood loss volume during operation was 5-50 ml(mean=20 ml).None of the patients suffered from complications.According to the follow-up toward 120 patients,among the 70 ones with dysmenorrhea,38 got rid of the pain and 8 got obvious alleviation with a total efficiency of 65.7%.Among the 40 patients with sterility,40 became pregnant with a percentage of 42.6%.Conclusion Celioscopy is effective and safe for endometriosis,and the patients is easy to recover.Especially,it is fit for those with complicated sterility because of its dual outcomes,i.e.diagnosis and therapy.