Laparoscopic surgery in the treatment of 86 patients with pelvic endometriosis compicated with infertility

腹腔镜手术治疗盆腔子宫内膜异位症合并不孕86例 Laparoscopic surgery in the treatment of 86 patients with pelvic endometriosis compicated with infertility 摘要目的 观察腹腔镜诊治盆腔子宫内膜异位症合并不孕症的疗效.方法 选择86例经腹腔镜诊断为盆腔子宫内膜异位症的患者,按美国生育学会修订的子宫内膜异位症分期标准(r-AFS)进行分期,其中Ⅰ期16例,Ⅱ期39例,Ⅲ期22例,Ⅳ期9例；于腹腔镜下行卵巢异位内膜病灶切除和粘连分解、盆腔腹膜异位内膜病灶内凝固术及清除腹腔液等手术治疗.术后随访36周,对妊娠者随访至妊娠20周.比较不同r-AFS分期患者术后累计妊娠率.结果 86例患者术后36周内妊娠共61例,Ⅰ期12例(75.0％,12/16),Ⅱ期28例(71.8％,28/39),Ⅲ期15例(68.2％,15/22)和Ⅳ期6例(66.7％,6/9).经统计学检验,各期患者累计妊娠率比较差异无统计学意义(P＞0.05)；术后24周内的妊娠率(70.5％,43/61)高于术后25～36周(29.5％,18/61),差异有统计学意义(P＜0.01).结论 应用腹腔镜可显著提升子宫内膜异位症的诊断水平,腹腔镜手术治疗可提高子宫内膜异位症患者的妊娠率.在腹腔镜下清除腹腔液及进行腹腔异位内膜病灶内凝固术,可较完全地破坏盆腔腹膜异位内膜病灶,对各期特别是Ⅰ、Ⅱ期子宫内膜异位症患者生育力的恢复有重要作用. 更多相关知识 abstractsObjective To observe the effect of laparoscopy on diagnosis and treatment of pelvic endometriosis complicated with infertility.Methods Totally 86 cases of endometriosis complicated with infertility diagnosed by laparoscopy were choosed.According to the revised classification of American Fertility Society (r-AFS),there were 6 cases of stage Ⅰ,39 cases of stage Ⅱ,22 cases of stage Ⅲ,9cases of stage Ⅳ.Operation were done under laparoscopy,with ovary ectopic endometrium resection and pelvic peritoneal adhesions decomposition,ectopic endometrium solidified operation and removal of the peritoneal fluid.All patients were followed up for 36 weeks,pregnancy follow-up to 20 weeks.The postoperative cumulative pregnancy rates were compared between different r-AFS stage patients.Results Of all the 86 cases,a total of 61 cases of pregnancy during 36 weeks after surgery,stage Ⅰ in 12 cases (75.0％,12/16),stage Ⅱ in 28 cases (71.8％,28/39),stage Ⅲ in 15 cases (68.2％,15/22) and stage Ⅳ in 6 cases (66.7％,6/9).There was no significant difference in cumulative pregnanay rate among different stages (P ＞0.05).The pregnancy rate (70.5％,43/61) during 24 weeks after surgery was higher than that during 25-36 weeks after surgery (29.5％,18/61),there was significant difference (P ＜ 0.01).Conclusions Laparoscopy can significantly improve the diagnosis of endometriosis and pregnancy rate in patients with endometriosis.Cleaning the peritoneal fluid and abdominal ectopic endometrial lesions,coagulation,may more thoroughly destroy the pelvic peritoneal ectopic endometrial lesions,so it plays an importment role in fertility recovery of uterine endometriosis patients,espicially for patients with stage Ⅰ and Ⅱ. More相关知识 - 浏览149 - 被引0 - 下载8 相似文献 - 中文期刊 - 外文期刊 - 学位论文 - 会议论文