摘要
目的分析腹腔镜手术治疗子宫内膜异位症合并不孕的效果。方法57例子宫内膜异位症合并不孕患者,均采用腹腔镜手术治疗。记录患者术中出血量、手术时间、术后排气时间、术后尿管留置时间、住院时间、术后使用抗生素时间,观察术后并发症发生情况;随访1年,评定患者生活质量改善情况,观察患者妊娠率和正常分娩率;比较18例腹腔镜术后联合应用促性腺激素释放激素激动剂(GnRH-a)治疗患者治疗前后的症状评分。结果57例患者的术中出血量为(98.62±0.84)ml、手术时间为(62.35±9.01)min、术后排气时间为(1.22±0.14)d、术后尿管留置时间为(2.09±0.98)d、住院时间为(3.96±1.07)d、术后使用抗生素时间为(2.18±0.45)d。患者术后无严重并发症出现,治疗期间出现恶心呕吐1例、腹胀1例,并发症发生率为3.51%。患者手术后的生活质量评分为(73.48±2.49)分,高于手术前的(45.28±2.16)分,差异具有统计学意义(P<0.05)。57例患者中妊娠11例(19.30%),正常分娩9例(15.79%)。治疗后,患者的潮热出汗、骨关节痛、性生活质量评分分别为(7.17±1.00)、(1.43±0.51)、(1.00±0.44)分,均低于治疗前的(9.10±2.12)、(2.02±0.94)、(1.43±0.58)分,差异具有统计学意义(P<0.05);治疗前后的情绪波动、眩晕评分比较,差异无统计学意义(P>0.05)。结论对子宫内膜异位症合并不孕患者采用腹腔镜手术治疗效果良好,可减少开腹手术带来的创伤,降低术后并发症,促进其恢复。能在一定程度上提高患者的妊娠率和正常分娩率,提升其生活质量。同时患者腹腔镜术后联合应用GnRH-a治疗可发挥重要作用,临床应用价值确切。
Objective To analyze the effect of laparoscopic surgery on endometriosis with infertility.Methods 57 patients with endometriosis combined with infertility were treated with laparoscopic surgery.The amount of intraoperative blood loss,operative time,postoperative exhaust time,postoperative catheter retention time,hospital stay,postoperative antibiotic use time were recorded,and the occurrence of postoperative complications were observed.All patients were followed up for 1 year to evaluate the improvement of their quality of life and observe the pregnancy rate and normal delivery rate.Symptom scores of 18 patients treated with gonadotropin-releasing hormone agonist(GnRH-a)after laparoscopic surgery were compared before and after treatment.Results In 57 patients,the amount of intraoperative blood loss was(98.62±0.84)ml,the operative time was(62.35±9.01)min,the postoperative exhaust time was(1.22±0.14)d,the postoperative catheter retention time was(2.09±0.98)d,the hospital stay was(3.96±1.07)d,and the postoperative antibiotic use time was(2.18±0.45)d.There were no serious complications after surgery,and 1 case of nausea and vomiting and 1 case of abdominal distension occurred during the treatment,with a complication rate of 3.51%.The quality of life score of the patients after surgery was(73.48±2.49)points,which was higher than that of(45.28±2.16)points before surgery,and the difference was statistically significant(P<0.05).There were 11 pregnancies(19.30%)and 9 normal deliveries(15.79%)among 57 patients.After treatment,the scores of hot flashes and sweating,bone and joint pain,and sexual quality of life were(7.17±1.00),(1.43±0.51),and(1.00±0.44)points,which were lower than those of(9.10±2.12),(2.02±0.94),and(1.43±0.58)points before treatment,and the differences were statistically significant(P<0.05).The differences in mood fluctuation and vertigo scores before and after treatment were not statistically significant(P>0.05).Conclusion Laparoscopic surgery is effective for the treatment of endometriosis with infertility,which can reduce the trauma caused by open surgery,reduce postoperative complications,and promote recovery.It can improve the pregnancy rate and normal delivery rate to a certain extent,and improve their quality of life.In addition,the combined treatment of GnRH-a after laparoscopic surgery can play an important role,and the clinical application value is definite.
作者
徐玉伟
XU Yu-wei(Obstetrics and Gynecology Department,People's Hospital of Wudi County,Binzhou 251900,China)
出处
《中国现代药物应用》
2023年第15期25-28,共4页
Chinese Journal of Modern Drug Application
