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目的 :探讨电视腹腔镜下诊断与保守性手术治疗子宫内膜异位症的临床疗效。方法 :选择 1997年 1月～2 0 0 0年 6月间在电视腹腔镜下诊断与保守性手术治疗子宫内膜异位症 46例进行前瞻性研究。采用美国SO LOS公司生产的电视腹腔镜和德国WISAP公司生产的手术器械。 46例内膜异位症均在电视腹腔镜下进行诊断并完成手术。其中对Ⅰ～Ⅱ期 2 9例内膜异位症均采用单纯内凝法治疗 ,术后不加用药物治疗内膜异位症 ;Ⅲ～Ⅳ期 17例内膜异位症采用内凝、双极电凝切除病灶 ,术后配合药物综合治疗。对伴内膜样囊肿 15例 ,11例行内膜样囊肿剥除术 ,4例行附件切除术 ;对合并不孕的 36例全部采用美兰混合液行输卵管通液术 ,通液术中发现输卵管远端梗阻 15根 ,均行输卵管造口术。结果 :46例子宫内膜异位症患者伴各种疼痛 39例 ,术后疼痛消失 18例 ,减轻 17例 ,有效率 87.4% ;36例不孕者术后妊娠 17例 ,受孕率 47.2 2 % ;内膜样囊肿15例 ,术后复发 2例 ,复发率 13.33%。结论 :腹腔镜下诊断与保守性手术治疗子宫内膜异位症安全、方便、疗效满意
Objective: To investigate the clinical efficacy of laparoscopic diagnosis and conservative surgery for endometriosis. Methods: From January 1997 to June 2004, 46 cases of endometriosis were diagnosed by laparoscopy and conservative surgery by TV. The prospective study was conducted. The use of the United States SO LOS TV laparoscopic production company and Germany WISAP company’s surgical instruments. All 46 cases of endometriosis were diagnosed by laparoscopy and completed the operation. Among them, 29 cases of endometriosis in stage Ⅰ ~ Ⅱ were treated with simple internal coagulation method, and no drug was used to treat endometriosis after operation. Seventeen cases of endometriosis in stages Ⅲ ~ Ⅳ were treated with endo-coagulation, Bipolar coagulation removal of the lesion, combined with comprehensive treatment of drugs. Of 15 cases with endometrioid cyst, 11 cases of endometrioid cyst excision, 4 cases of attachment excision; 36 cases of infertility all with Meilan mixture of tubal fluid, surgical Tubal distal obstruction found 15, both underwent tubal ostomy. Results: 46 cases of endometriosis patients with various pain in 39 cases, postoperative pain disappeared in 18 cases, 17 cases reduced, the effective rate was 87.4%; 36 cases of infertility in 17 cases of pregnancy, pregnancy rate 47.2 2% ; Endometrioid cyst in 15 cases, 2 cases of recurrence, the recurrence rate was 13.33%. Conclusion: Laparoscopic diagnosis and conservative surgery for endometriosis is safe, convenient and effective