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目的:探讨腹腔镜在子宫内膜异位症(EMT)相关性慢性盆腔痛诊治中的应用。方法:回顾性研究212例行腹腔镜手术的子宫内膜异位症慢性盆腔痛患者的手术治疗方法和效果。结果:腹腔镜诊治EMT相关性慢性盆腔痛缓解率为89.6%。EMT I期患者均为I度疼痛;II期患者I度疼痛占68.6%(48/70);III期和IV期患者II度以上疼痛占74.0%(80/108)。卵巢巧克力囊肿和盆腔腹膜EMT患者以I、II度疼痛为主,占74.3%(104/140),病灶侵犯子宫后壁、道格拉斯窝、双侧骶韧带、直肠子宫陷凹及深部浸润的EMT患者II、III度疼痛占94.3%。结论:腹腔镜能明确诊断及治疗EMT相关性慢性盆腔痛,腹腔镜具有手术时间短、术后恢复快、住院时间短等优点,且阐明了盆腔子宫内膜异位症侵犯子宫后壁、道格拉斯窝、双侧骶韧带、直肠子宫陷凹及深部浸润是引起EMT相关性盆腔疼痛的主要原因,治疗效果满意,值得临床推广。
Objective: To investigate the application of laparoscopy in diagnosis and treatment of chronic pelvic pain associated with endometriosis (EMT). Methods: A retrospective study of surgical treatment of 212 cases of chronic pelvic pain patients with endometriosis undergoing laparoscopic surgery. Results: The response rate of laparoscopic diagnosis and treatment of chronic pelvic pain associated with EMT was 89.6%. Patients with EMT stage I had pain of 1 degree, I degree of pain of stage II accounted for 68.6% (48/70), patients with stage II and III pain accounted for 74.0% (80/108). Ovarian chocolate cysts and pelvic peritoneal EMT patients with I, II degree of pain, accounting for 74.3% (104/140), the lesions invade the posterior wall of the uterus, Douglas swoop, bilateral sacral ligament, rectal uterine depression and deep infiltration of EMT patients II, III degree pain accounted for 94.3%. Conclusion: Laparoscopy can diagnose and treat chronic pelvic pain associated with EMT. Laparoscopy has the advantages of short operative time, quick recovery after surgery, short hospitalization time, etc. It also clarifies that pelvic endometriosis invading the posterior uterine wall, Douglas Fossa, bilateral sacral ligament, rectal uterine depression and deep infiltration is the main cause of EMT-related pelvic pain, the treatment effect is satisfactory, worthy of clinical promotion.