腹腔镜手术联合地塞米松术腔冲洗治疗子宫内膜异位症的疗效观察  

Clinical Efficacy of Laparoscopic Operation Combined with Dexamethasone Cavity Flushing in Endometriosis

作　　者：冯子豪[1] 蒋苹[1] 韩雪松[2] 黄燕[1] 王川[1] 

机构地区：[1]昆明医科大学附属甘美医院妇科,云南昆明650011 [2]昆明医科大学第一附属医院妇科,云南昆明650032

出　　处：《昆明医科大学学报》2016年第3期96-99,共4页Journal of Kunming Medical University

基　　金：云南省科技厅应用基础研究基金资助项目(2010ZC122)

摘　　要：目的检测子宫内膜异位症(EMS)患者围术期血清CRP、IL-6、TNF-α的水平变化,探讨腹腔镜手术联合地塞米松术腔冲洗治疗EMS的临床疗效.方法选择2013年11月至2014年12月在昆明医科大学附属甘美医院施行EMS手术的患者80例,其中,单纯施行腹腔镜手术的患者20例(L组),施行腹腔镜手术并在术中予地塞米松冲洗术腔的患者20例(LD组),单纯施行开腹手术的患者20例(O组),施行开腹手术并在术中予地塞米松冲洗术腔的患者20例(OD组).所有患者均在术前、术后第1、3天测定血清CRP、IL-6、TNF-α含量.结果 4组患者术后血清炎性因子水平较术前明显升高,其中LD组术后血清CRP、IL-6、TNF-α含量升高幅度最小,且数值最低,并在术后第3天可恢复至接近术前水平(P<0.05).结论腹腔镜手术联合地塞米松术腔冲洗治疗EMS效果良好,无明显不良反应.Objective To explore the changes in serum levels of CRP, IL-6 and TNF-α in patients with endometriosis（EMS）,and evaluate the clinical efficacy of laparoscopic operation combined with dexamethasone cavity flushing in endometriosis. Methods From November 2013 to December 2014, 80 patients underwent endometriosis surgery in our hospital including simple laparoscopic surgery in 20 patients（L group）,laparoscopic surgery combined with dexamethasone cavity flushing in 20 patients（LD group）, simple open operation in 20patients（O group）,and open operation combined with dexamethasone cavity flushing in 20 patients（OD group）.The serum levels of CRP, IL-6 and TNF-α in all patients were tested before surgery and on the first and third postoperative days. Results Postoperative serum inflammatory factor levels of all groups were increased significantly.The postoperative serum levels of CRP, IL-6 and TNF-α in LD group were increased mildest with the minimum values, and the values could recover to the preoperative level closely on the third postoperative days（P〈0.05）.Conclusion Laparoscopic operation combined with dexamethasone cavity flushing has definite clinical effect on endometriosis and less adverse reactions.

关 键 词：子宫内膜异位症 腹腔镜 地塞米松 细胞免疫 

分 类 号：R711.71[医药卫生—妇产科学]