盆腔子宫内膜异位症手术治疗临床分析  

Clinical analysis of surgical management of pelvic endometriosis

作　　者：朱鹃[1] 卞美璐[1] 张庆霞[1] 林华[1] 孙霭萍[1] 李敏[1] 王扬[1] 

机构地区：[1]中日友好医院妇产科,北京100029

出　　处：《中日友好医院学报》2010年第3期140-142,共3页Journal of China-Japan Friendship Hospital

摘　　要：目的:总结盆腔子宫内膜异位症手术的特点及评估腹腔镜手术的优势。方法:回顾性分析2007～2009年中日友好医院322例盆腔子宫内膜异位症患者的手术途径(腹腔镜与开腹手术)及手术方式(保守性手术,半根治手术和根治性手术)的构成比,比较腹腔镜手术与开腹手术的术中及术后情况。结果:腹腔镜手术呈逐年上升趋势。保守性手术占84.47%(272/322),根治性手术和半根治性手术占15.53%(50/322)。在保守性手术中腹腔镜手术占69.49%,开腹手术占30.51%。腹腔镜手术与开腹手术相比,术中出血量较少,术后最高体温和术后病率较低,术后排气时间较短,无切口感染发生。保守性手术中腹腔镜手术时间较短,在半根治手术和根治性手术中,腹腔镜手术时间较长。结论:腹腔镜手术和保守性手术是盆腔子宫内膜异位症手术中的主要途径和方式。腹腔镜手术具有微创、恢复快、术后疼痛轻、感染率低的特点,是盆腔子宫内膜异位症的首选手术途径。Objective：To study the characteristic of surgical approaches on pelvic endometriosis and to evaluate the advantage of the laparoscopic surgery.Methods：The proportion of surgical approaches （laparoscopic surgery and laparotomic surgery） and methods （conservative surgery, subradical surgery and radical surgery）in 322 cases of pelvic endometriosis from 2007 to 2009 in China-Japan Friendship Hospital were retrospectively analyzed.The operative and postoperative indexes were compared between laparoscopic surgery and laparotomic surgery.Results：The amount of laparoscopic surgery was increasing gradually.The percentage of conservative surgery was 84.47%（272/322）,the percentage of radical surgery and subradical surgery was 15.53%（50/322）. Of conservative surgery the percentage of laparoscopic surgery was 69.49%（189/272）,the percentage of laparotomic surgery was 30.51% （83/272）.Compared with laparotomic surgery, laparoscopic surgery was associated with less intra-operative blood loss, lower postoperative temperature and postoperative pyrexia,shorter time of exsufflation following surgery,less posteroperative use of analgesic and no incision infection.The laparoscopic surgery was associated with shorter operative time in conservative surgery while it was associated with longer operative time in subradical surgery and radical surgery.Conclusion：Laparoscopic surgery and conservative surgery are major surgical approaches on pelvic endometriosis.Laparoscopic surgery is associated with minimal invasion, accelerated recovery,more slightly postoperative pain,low infection,and it is optima option of surgery approaches of pelvic endometriosis.

关 键 词：子宫内膜异位症 腹腔镜 开腹手术 保守手术 

分 类 号：R713[医药卫生—妇产科学]