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目的探讨腹腔镜手术联合孕三烯酮治疗子宫内膜异位症的应用价值。方法对85例子宫内膜异位症施行腹腔镜下盆腔粘连松解术、输卵管伞部造口术、巧克力囊肿剥除术及盆腔异位病灶电凝术。与同期条件相当的56例剖腹手术进行比较。结果腹腔镜手术组术中出血量、肛门排气时间、术后病率、术后平均住院日、术后恢复时间分别为(66±9)m、l(22±5)h、17.1%、(3.3±1.1)d、(10.1±2.9)d,与剖腹手术组比较差异有统计学意义(P<0.01)。腹腔镜组术后无一例用镇痛药,术后6h拔除尿管、进食及下床活动,术后随访6个月~3年,腹腔镜组及腹剖组手术疼痛缓解有效率、月经异常恢复正常率、术后妊娠率、内异症复发率分别为100%、100%,64.29%、62.50%,65.12%、61.54%,3.53%、3.57%。结论腹腔镜下行子宫内膜异位症手术安全、有效,术后辅以孕三烯酮治疗能有效控制临床症状,延迟病灶复发时间,降低复发率,提高妊娠率。
Objective To investigate the value of laparoscopic surgery combined with gestrinone in the treatment of endometriosis. Methods 85 cases of endometriosis underwent laparoscopic pelvic adhesiolysis, tubal umbrella stoma, chocolate cyst excision and pelvic ectopic coagulation. 56 cases of laparotomy comparable with the same period were compared. Results The intraoperative bleeding, anal exhaust time, postoperative morbidity, postoperative average length of stay and postoperative recovery time were (66 ± 9) m, l (22 ± 5) h and 17.1% in laparoscopic operation group, (3.3 ± 1.1) d, (10.1 ± 2.9) d, respectively. There were significant differences between the two groups (P <0.01). No cases of laparoscopic surgery with analgesics, 6h after removal of the catheter, feeding and ambulation, were followed up for 6 months to 3 years, laparoscopic and abdominal surgery group pain relief efficiency, abnormal menstruation The recurrence rate, postoperative pregnancy rate and endometriosis recurrence rate were 100%, 100%, 64.29%, 62.50%, 65.12%, 61.54%, 3.53%, 3.57% respectively. Conclusions Laparoscopic surgery for endometriosis is safe and effective. After treatment, gestrinone treatment can effectively control the clinical symptoms, delay the time of recurrence, reduce the recurrence rate and improve the pregnancy rate.