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目的:评价重度子宫内膜异位症腹腔镜手术治疗的临床价值。方法:回顾性总结了121例重度子宫内膜异位症(Ⅲ期67例,Ⅳ期54例),在腹腔镜下进行诊断并完成手术的临床经验。结果:121例患者中行保留生育功能手术者77例(其中单纯囊肿剥除者46例,单附件切除者31例);保留卵巢功能手术35例;根治性手术9例。三种手术手术时间分别为15～100min、30～126min、40～120min,平均分别为61.97min、77.14min、81.11min。术中出血量分别为5～150ml,10～100ml,40～150ml,平均分别为65.78ml,59.86ml,100.56ml。均无严重并发症发生。随访92例,痛经51例中31例痛经症状消失,11例明显减轻,总有效率82.3%。有生育要求的45例中21例妊娠,妊娠率46.7%。结论:腹腔镜手术治疗重度子宫内膜异位症安全、有效、恢复快,尤其对合并不孕症患者,既可明确诊断,又可同时治疗,提高妊娠率。
Objective: To evaluate the clinical value of laparoscopic surgery for severe endometriosis. Methods: 121 cases of severe endometriosis (67 in stage Ⅲ and 54 in stage Ⅳ) were retrospectively reviewed. The clinical experience of laparoscopic diagnosis and complete operation were summarized. Results: Among the 121 patients, 77 cases were retained with fertility surgery (including 46 cases with simple cyst excision and 31 cases with single attachment excision). 35 cases retained ovarian function and 9 cases operated under radical operation. The three operation time were 15 ~ 100min, 30 ~ 126min, 40 ~ 120min, the average was 61.97min, 77.14min, 81.11min. Intraoperative blood loss were 5 ~ 150ml, 10 ~ 100ml, 40 ~ 150ml, with an average of 65.78ml, 59.86ml, 100.56ml. No serious complications occurred. Follow-up 92 cases, dysmenorrhea in 51 cases of dysmenorrhea symptoms disappeared in 11 cases were significantly reduced, the total effective rate was 82.3%. Among the 45 cases requiring fertility, 21 were pregnant and the pregnancy rate was 46.7%. Conclusion: Laparoscopic surgery for severe endometriosis is safe, effective and rapid recovery, especially for patients with infertility, which can not only confirm the diagnosis but also treat at the same time to improve the pregnancy rate.