Clinical study of effect of laparoscopic diagnosis and treatment on pelvic endometriosis-associated infertility

林金芳, 孙翠翔, 华克勤, 薛晓红, 李央
In: Chin J Obstet Gynecol · 2005 · vol. 40(01) , pp. 9–12 · doi:10.3760/j.issn:0529-567x.2005.01.004 · W3031006439
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-07-15 ⓘ

Laparoscopic diagnosis and treatment of pelvic endometriosis were performed on 314 patients, improving pregnancy rates with no significant difference between stages, though earlier pregnancies and earlier miscarriages were more common.

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This clinical study evaluated 314 patients diagnosed by laparoscopy with pelvic endometriosis-associated infertility, staged using the revised American Fertility Society (r-AFS) system (I–IV stages). Under laparoscopic visualization, patients underwent ovarian endometriosis lesion excision, adhesiolysis, coagulation/ablation of pelvic peritoneal endometriosis lesions, and clearing of peritoneal fluid, followed by 36-week follow-up (with ongoing follow-up to 20 weeks for those who conceived). The cumulative pregnancy rates within 36 weeks were high across all stages (about 73–86%) and did not differ significantly by r-AFS stage, while conception occurred mainly before 24 weeks (93.7% vs 6.3% after 25–36 weeks), with 12 miscarriages overall; miscarriage rates were not associated with stage, but early miscarriage (within 12 weeks) was more frequent than later. This paper is centrally about endometriosis — it studies laparoscopic diagnosis and treatment outcomes for pelvic endometriosis-associated infertility across r-AFS stages and pregnancy/miscarriage timing.

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Abstract

目的 观察应用腹腔镜诊断和治疗盆腔子宫内膜异位症(内异症)及不孕症的疗效.方法对 314例经腹腔镜诊断为盆腔内异症的患者,按1985年美国生育学会修订的内异症分期标准(r-AFS)进行分期,其中Ⅰ期58例,Ⅱ期173例,Ⅲ期68例,Ⅳ期15例;并于腹腔镜下进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,对妊娠者随访到妊娠20周.比较不同r-AFS分期患者术后累计妊娠率和流产率.结果 314例患者术后36周内妊娠共254例,分别为Ⅰ期50例(86.2%,50/58),Ⅱ期141例(81.5%,141/173),Ⅲ期52例(76.5%,52/68)和Ⅳ期11例(73.3%,11/15).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(93.7%,238/254)高于术后25～36周(6.3%,16/254;P 0.05);妊娠12周内流产率(83.3%,10/12)高于妊娠12周后(16.7%,2/12; P<0.05).结论应用腹腔镜可检查、诊断各期内异症及其引起不孕症的盆腔因素;腹腔镜手术治疗可提高内异症患者的妊娠率.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期内异症患者生育力的恢复,有重要作用。
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应用腹腔镜诊断和治疗子宫内膜异位症及不孕症的疗效 Clinical study of effect of laparoscopic diagnosis and treatment on pelvic endometriosis-associated infertility 摘要目的观察应用腹腔镜诊断和治疗盆腔子宫内膜异位症(内异症)及不孕症的疗效.方法对 314例经腹腔镜诊断为盆腔内异症的患者,按1985年美国生育学会修订的内异症分期标准(r-AFS)进行分期,其中Ⅰ期58例,Ⅱ期173例,Ⅲ期68例,Ⅳ期15例;并于腹腔镜下进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,对妊娠者随访到妊娠20周.比较不同r-AFS分期患者术后累计妊娠率和流产率.结果 314例患者术后36周内妊娠共254例,分别为Ⅰ期50例(86.2%,50/58),Ⅱ期141例(81.5%,141/173),Ⅲ期52例(76.5%,52/68)和Ⅳ期11例(73.3%,11/15).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(93.7%,238/254)高于术后25～36周(6.3%,16/254;P0.05);妊娠12周内流产率(83.3%,10/12)高于妊娠12周后(16.7%,2/12; P<0.05).结论应用腹腔镜可检查、诊断各期内异症及其引起不孕症的盆腔因素;腹腔镜手术治疗可提高内异症患者的妊娠率.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期内异症患者生育力的恢复,有重要作用. 更多相关知识 - 浏览839 - 被引244 - 下载708 相似文献 - 中文期刊 - 外文期刊 - 学位论文 - 会议论文

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