腹腔镜治疗子宫内膜异位症合并不孕症的疗效分析

目的探讨腹腔镜治疗子宫内膜异位症合并不孕症的疗效分析。方法我院收治的子宫内膜异位症合并不孕患者110例,按照手术方法的不同,分为腹腔镜组和开腹组,两组各55例,观察两组手术时间、术中出血量、住院时间和术后并发症,检测高敏C反应蛋白（hs-CRP）和前白蛋白（PA）,随访半年妊娠率、1年妊娠率和1年内膜异位症复发率。结果腹腔镜组的手术时间、术中出血量、住院时间和术后并发症分别为（55.87±22.73）min、（43.37±12.72）ml、（4.76±1.06）d和7.27%,均较开腹组短或者减少,差异有统计学意义（P〈0.01）。两组半年妊娠率、1年妊娠率和子宫内膜异位症复发率接近,差异无统计学意义（P〉0.05）。手术后,两组的hs-CRP和PA水平均较术前明显升高或者下降,但开腹组的升高或降低水平更为明显,差异有统计学意义（P〈0.01）。结论腹腔镜治疗子宫内膜异位症具有手术创伤小,术后微炎症反应轻,恢复时间短等特点,是一种具有发展前景的新技术。

Clinical study of laparoscopic operations on treatment of endometriosis associated with infertility

Objective To evaluate the efficacy of laparoscopic operations on treatment of endometriosis associated with infertility. Methods 110 patients with endometriosis associated with infertility, according to the different surgical methods, were divided into laparoscopic group and laparotomy group,each group with 55 cases. The operative time, intraoperative blood loss, hospital stay, postoperative complications, high-sensitivity C-reactive protein （hs-CRP）, prealbumin （PA）, half-year pregnancy rate, one-year pregnancy rate and 1-year recurrence rate of endometriosis were observed. Results The operative time, intraoperative blood loss, hospital stay and postoperative complications in the laparoscopic group were short or reduced than those in the laparotomy group; the difference was statistically significant （P0.01）. The half-year pregnancy rate, one-year pregnancy rate and 1-year recurrence rate of endometriosis were not statistically different in two groups（P0.05）. After surgery, the levels of hs-CRP and PA were significantly higher or decreased than those before operation, but the levels of hs-CRP and PA in the laparotomy group were significantly higher or decreased than those in the laparoscopic group. The difference was statistically significant（P0.01）. Conclusions Laparoscopic treatment of endometriosis is a minimally invasive method, with mild postoperative inflammation, and short recovery time. It is a kind of promising new technology.