腹腔镜保守性手术治疗盆腔子宫内膜异位症的临床特点及疗效分析

科研成果详情

题名	腹腔镜保守性手术治疗盆腔子宫内膜异位症的临床特点及疗效分析
其他题名	Clinical characteristics and treatment?effect in patients with pelvic endometriosis,who are given to laparoscopic and conservative surgery
作者	黄春
学位类型	硕士
导师	吕杰强
答辩日期	2015-06-03
学位授予单位	温州医科大学
学位专业	妇产科学
关键词	子宫内膜异位症临床特点腹腔镜保守性手术手术疗效
摘要	目的：回顾性分析腹腔镜保守治疗的盆腔子宫内膜异位症患者其AFS分期情况（美国生育学会提出的修正子宫内膜异位症分期法)，探讨AFS各期患者的临床特点及疗效的差别。方法：收集2012年1月至2014年12月就诊于温州医科大学附属第二医院并行腹腔镜手术治疗子宫内膜异位症患者的临床资料，对患者进行随访，随访内容为术后用药情况、症状缓解情况、复发及妊娠情况。根据患者AFS分期情况，探讨各期患者的临床特点及疗效情况。结果：共纳入患者540例，所有患者年龄范围19～44岁，中位年龄32岁。患者主要因盆腔包块及不孕症行手术治疗，盆腔疼痛为伴随症状，较少成为手术原因。AFS各期患者比较：1、术前血CA125阳性百分比：AFS各期患者中血CA125阳性百分比随AFS分期的增加呈递增趋势，II期与III期比较差异无统计学意义((P>0.05)，其余各期比较均有统计学意义(P0.05)，其余各期比较均有显著性差异 (P0.05)，其余各期比较均有差异(P0.05)；其余各期比较均有明显差异（P0.05)，其余各期比较均有差异(P0.05)。7、术后妊娠率：不孕患者术后妊娠率比较：IV期不孕患者妊娠率高于I期及III期不孕患者(P0.05)。术后总的妊娠率比较：随AFS各期增加，患者中总的术后妊娠率逐渐降低，I期与II期，III期与IV期比较无明显差异(P>0.05)；其余各期比较均有明显差异(P0.05)。结论：患者主要因盆腔包块及不孕症行手术治疗，盆腔疼痛为伴随症状，较少成为手术原因；内异症患者血CA125阳性率随AFS分期增加而递增；AFS各期患者保守性手术后盆腔包块复发率无明显差别；对AFS分期较高的内异症患者，为提高妊娠率，术后应积极ART治疗。
其他摘要	Objective:To investigate the clinical characteristics and the curative effect among pelvic endometriosis,who are given to laparoscopic and conservative surgery.All the patients were divided into group I,group II, group III and group IV according to the AFS .Methods: Collected the clinical data of patients with endometriosis, who were given to laparoscopic and conservative surgery in the Second Affiliated Hospital of Wenzhou Medical University from January 2012 to December 2014.All of the patients underwent a follow-up on the surgical effectiveness.Analyzed the patients clinical characteristics and curative effect.Results:The age of all the patients ranged from 19 to 44 years old, The patients’ median age was 32 years old. Patients with primary surgical treatment for pelvic mass and infertility, pelvic pain is not a main reason for the surgery. Compare the differences between AFS:1.Preoperative blood CA125 positive percentage：With the increases of the AFS,the percent of the patients whose CA125 was positive was increased, group II and group III had no significant difference(P>0.05); all of the other intercomparison had significant difference(P0.05);roup III and group IV had no significant difference(P>0.05);all of the other intercomparison had significant difference(P0.05);all of the other intercomparison had significant difference(P0.05);all of the other intercomparison had significant difference(P0.05); all of the other intercomparison had significant difference(P0.05).7.The rate of pregnancy after surgery:The rate of pregnancy in infertility：The group IV is higher than group I and group III(P0.05);all of the other intercomparison in the four group had significant differencev(P0.05).Conclusion:The patients performed mainly due to pelvic mass and infertility，Pelvic pain is just a associated symptom,not the key factor of surgery；Before operation, CA125 positive rate increasing with the increase of AFS installment； The relapse rate of pelvic mass had no significant difference between groups；patients with higher AFS stage should be active treatment through ART to improve the rate of pregnancy through ART.
语种	中文
学号	121002047
发布年限	2017-06-03
毕业论文分类号	0R71
原始专题	第二临床学院
学位论文研究方向	妇科肿瘤
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全文文件名	121002047黄春2015妇产科学.pdf\|121002047黄春2015妇产科学.pdf
文献类型	学位论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/115913
专题	温州医科大学
作者单位	溫州医科大学第二临床学院
推荐引用方式 GB/T 7714	黄春. 腹腔镜保守性手术治疗盆腔子宫内膜异位症的临床特点及疗效分析[D]. 温州医科大学,2015.