腹腔镜诊治子宫内膜异位症相关性慢性盆腔痛的临床研究  

Combined Treatment of Endometriosis-Related Chronic Pelvic Pain with Laparoscopy

作　　者：胡碧洪[1] 李莉芳[1] 王帅[1] 黄浩[1] 

机构地区：[1]南方医科大学附属南海医院,广东佛山528200

出　　处：《实用妇产科杂志》2011年第10期751-753,共3页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:评价腹腔镜在子宫内膜异位症(EMT)相关性慢性盆腔痛诊断及治疗中的应用价值。方法:回顾性分析86例EMT相关性慢性盆腔痛患者行腹腔镜手术治疗的效果及疼痛程度与EMT分期及部位的关系。结果:腹腔镜手术治疗EMT相关性慢性盆腔痛疼痛缓解率90.7%。rAFS分期Ⅱ期患者Ⅰ度疼痛占71.4%,Ⅲ期和Ⅳ期患者Ⅱ度以上疼痛占95.5%。单纯卵巢巧克力囊肿和(或)盆腔腹膜EMT患者Ⅰ、Ⅱ度疼痛占88.4%,病灶侵犯宫骶韧带、直肠子宫陷凹和子宫后壁以及深部浸润的EMT患者Ⅱ、Ⅲ度疼痛占93.0%。结论:盆腔子宫内膜异位病灶侵犯宫骶韧带、直肠子宫陷凹、子宫后壁和深部浸润是引起EMT相关性慢性盆腔痛的主要原因,腹腔镜能明确诊断及治疗EMT相关性慢性盆腔痛,治疗效果满意。Objective：To evaluate the diagnosis and treatment of endometriosis-related chronic pelvic pain（EMT-related CPP） by laparoscope.Methods：The relationship between site,stage of endometriosis（EMT） and the effect of laparoscope,as well as the pain degree in 86 cases of endometriosis-related chronic pelvic pain patients were retrospectively analyzed.Results：The remission rate of EMT-related CPP by laparoscopic surgery was 90.7%. Ⅰ degree of pain in Ⅱ stage by rAFS was 71.4%,more than Ⅱ degree of pain in Ⅲ and Ⅳ stage was 95.5%. Ⅰ and Ⅱ degree of pain in simple ovarian chocolate cysts and（or） pelvic peritoneum EMT pain was 88.4%. Ⅱ to Ⅲ degree of pain in EMT patients with ectopic lesions invasion of uterosacral ligaments,Douglas pouch,posterior wall of uterus and deep infiltrating was 93.0%.Conclusions：The main causes of EMT-related CPP are invasion of uetrosacral ligament,Douglas pouch,posterior wall of uterus and deep infiltrating in pelvic endometriosis. Laparoscopy can confirm the diagnosis and treat EMT-related CPP,the therapy is satisfactory.

关 键 词：腹腔镜 子宫内膜异位症 慢性盆腔痛 

分 类 号：R711.71[医药卫生—妇产科学]