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目的评价腹腔镜手术治疗子宫内膜异位症的临床价值。方法总结69例子宫内膜异位症(R-AFS分期I-Ⅳ期)在电视腹腔镜下进行诊断并完成手术的情况。结果69例全部通过腹腔镜成功完成手术。19例行卵巢子宫内膜异位囊肿剥除术,其中单侧15例,双侧4例。异位病灶电凝术61例,同时行粘连松解术42例,输卵管造口术13例,术中同时行子宫肌瘤剔除术4例,输卵管通液术35例,双侧输卵管通畅15例,单侧通畅11例,双侧均不通畅9例。手术时间30~126m in,平均79m in。术中出血10~80m l,平均25m l。均无严重并发症发生。随访痛经40例中21例痛经症状消失,12例明显减轻,总有效率82.5%。不孕35例中16例妊娠,妊娠率45.7%。结论腹腔镜手术治疗子宫内膜异位症安全、有效、恢复快,尤其对合并不孕症患者,既可明确诊断,又可同时治疗,提高妊娠率。
Objective To evaluate the clinical value of laparoscopic surgery for endometriosis. Methods A total of 69 cases of endometriosis (R-AFS stage I-IV) were diagnosed by laparoscopy and completed the operation. Results All 69 cases were successfully completed laparoscopic surgery. 19 cases of ovarian endometriosis cyst stripping surgery, including 15 cases of unilateral and bilateral in 4 cases. Ectopic electrocoagulation in 61 cases, simultaneous adhesiolysis in 42 cases, tubal ostomy in 13 cases, intraoperative simultaneous myomectomy in 4 cases, tubal fluid in 35 cases, bilateral tubal patency in 15 cases Unilateral unilateral in 11 cases, both sides are not smooth in 9 cases. Surgery time 30 ~ 126m in, an average of 79m in. Intraoperative bleeding 10 ~ 80m l, an average of 25m l. No serious complications occurred. Follow-up dysmenorrhea in 40 cases of 21 cases of dysmenorrhea symptoms disappeared, 12 cases significantly reduced, the total effective rate was 82.5%. Infertility 35 cases in 16 cases of pregnancy, pregnancy rate 45.7%. Conclusion Laparoscopic surgery for endometriosis is safe, effective and rapid recovery, especially for patients with infertility, can be a clear diagnosis, but also at the same time treatment to improve pregnancy rate.