子宫肌层内膜异位囊肿临床分析.docVIP

子宫肌层内膜异位囊肿临床分析 　　【摘要】目的研究腹腔镜下子宫肌层内膜异位囊肿手术的可行性和临床效果。 方法回顾分析2005年1月至2010年12月住院的术中诊断子宫肌层内膜异位囊肿16例，其中8例较年轻、有生育要求、囊肿单发位于浅肌层，行腹腔镜子宫内膜异位囊肿切除手术；另8例1例单发位置较深、年龄大于40岁， 7例为多发，均行腹腔镜辅助经阴道子宫全切术。结果16例手术腹腔镜下均完成顺利。结论子宫肌层内膜异位囊肿较少见，大部分患者均有痛经不孕等病史。采用腹腔镜的手术方式出血少，痛苦轻，恢复快，并发症少，是一种行之有效的治疗方法，尤其适合于单发外凸的年轻妇女。 　　【关键词】子宫肌层；内膜异位囊肿；腹腔镜 　　 　　作者单位：277100山东省枣庄市妇幼保健院(梁锋孙茂莲 　　乔明霞)；山东省枣庄市峄城区计划生育服务站(孙莉) 　　 　　 　　Clinical analysis of myometrium endometriotic cystLIANG Feng,SUN Li,SUN Mao-lian,et al.Maternal and Children care serivce lentre of Zaozhuang,Zaozhuang 277100,China 　　【Abstract】ObjectiveIn this study of we aimed to investigate feasibility and clinical results of laparoscopic removal of myometrium endometriotic cyst.MethodsWe retrospectively analysed the sixteen patients of myometrium endometriotic cyst from January 2005 to December 2010.Eight patients of single cysts located in the superficial muscle layer were younger, and had fertility requirements.One of another eight patients with single and deep cysts was old than 40.The rest of the seven patients have multiple cysts. All of the sixteen patients underwent laparoscopic surgical excision of the uterus lesions. Results16 cases of laparoscopic surgery were completed successfully. ConclusionMyometrial endometriosis cyst is less common, most patients had a history of dysmenorrhea and infertility. As an effective surgery way, Laparoscopic surgery is less bleeding, and of fewer complications, especially fit for fertility requirements of the single convex cyst. 　　【Key words】Myometrium;Endometriotic cyst;Laparoscopic 　　子宫内膜异位症是指具有活性的子宫内膜组织出现在子宫内膜以外部位时称为子宫内膜异位症。绝大部分位于盆腔内，以卵巢及宫骶韧带最常见，其次为子宫、直肠子宫凹、阴道直肠隔等部位［1］。子宫内膜异位囊肿???多发生在卵巢，俗称“巧克力囊肿”，子宫肌层出现内膜异位囊肿实属少见［2］。本文拟结合我院近6年来收治的16例子宫肌壁间内膜异位囊肿患者的临床诊疗经过进行分析，以其为少见部位子宫内膜异位症的诊疗提供借鉴，现报告如下。 　　1资料与方法 　　1.1一般资料本组16例子宫肌层内膜异位囊肿患者中，年龄最小21岁，最大49岁。表现为渐进性痛经15例，无痛1例，查体发现包块与子宫关系均密切。不孕症10例。其中8例囊肿位于浅肌层，单发；余8例1例囊肿单发位于子宫肌层深部，月经多，痛经明显；7例为多发、年龄均大于40岁,痛经明显；13例患者CA-125均有不同程度增高,最高421 U/L,月经量不规则增多12例。 　　1.2手术方法 　　1.2.1术前准备术前