腹腔镜手术联合物治疗卵巢子宫内膜异位囊肿.pdf

摘 要 腹腔镜手术联合药物治疗卵巢子宫内膜异位囊肿 研究生：温华惠 导师：马彩玲教授 摘 要 目的：探讨腹腔镜联合药物治疗卵巢子宫内膜异位囊肿的远期疗效。方法：回 顾性分析我院2006 年 6 月~2008 年6 月经腹腔镜手术治疗卵巢子宫内膜异位囊肿368 例，其中 200 例随访≥12 个月（12~24 月）。200 例均行囊肿剥除术，其中单侧 168 例，双侧 32 例；其中子宫切除加双侧囊肿剔除术 6 例；子宫切除加单侧囊肿剔除 30 例；术中同时行盆腔粘连松解术 174 例。不孕者同时行输卵管美兰通液术。术后 60 例口服米非司酮 3~6 个月，92 例皮下注射 GnRHa3~6 个月，有生育要求者不用药物 治疗，鼓励尽早妊娠。结果：200 例均在腹腔镜下完成，无中转开腹和并发症发生。 术后复发 18 例，复发率 9% 。48 例不孕患者中，22 例妊娠，妊娠率 45.8% ，均为宫 内妊娠，妊娠时间为术后3~15 月。110 例痛经者中，术后完全缓解 68 例（61.8% ）， 症状减轻 28 例（25.4% ），总有效率 87.2%。结论：腹腔镜手术治疗子宫内膜异位囊 肿创伤小，安全、有效，可重复使用。术后辅助药物治疗可能预防术后复发。 关键词：腹腔镜手术；药物治疗；子宫内膜异位囊肿 —1— 新疆医科大学医学硕士学位论文 Combinative Treatment of Laparoscopic Operation and Pharmacotherapy for endometrial cyst of the ovary Postgraduate: wenhuahui Supervisor: Prof. Ma Cailing Abstract Objective:To study the long-term effects of combination of laparoscopic operation and pharmaco-therapy on endometrial cyst of the ovary.Methods:Three hundred and sixty eight patients with endometriosis who underwent laparoscopic surgery in Xinjiang Medical University First Affiliated Hospital, 2006 to June, 2008 were analyzed retrospectively. In 368 patients,200 cases of follow-up ≥ 12 months (12 ~ 24 months).200 were treated by cystectomywith unilateral in 168 cases and bilateral in 32 ones.Six were treated by cystectomy and hysterectomy.Salpingo-oophorectomy and bilateral were performed in 30 cases.During the operation,adhesion separation was done in 174 cases.Hydrotubation with blue dyewere done to infertile patients during the surgery.60 cases of oral mifepristone after 3 ~ 6 months,92 cases of subcutaneous GnRHa 3 ~