| BackgroundEndometriosis(EMS)refers to a type of gynecological disease in which endometrial cells are grown outside the endometrium.The incidence of the disease depends on estrogen,and thus the incidence of common in women of childbearing age,the main symptoms of infertility,menstrual abnormalities,dysmenorrhea and sexual intercourse pain,prone to recurrence and metastasis.At present,surgical treatment is the preferred treatment for the disease,and has become a widely used treatment program.Because of the disease after conservative surgery easy to relapse characteristics,in order to make the residual body of some small pathogenic factors are inhibited,and then atrophy or even degeneration,to achieve the purpose of relapse and cure,postoperative combination of drug therapy has been widely used in clinical.ObjectiveRetrospectively observe the clinical effect of laparoscopic surgery combined with "dissipation" in the treatment of endometriosis,and provide a better treatment for endometriosis,aiming at reducing the recurrence rate and improving the pregnancy rate.Research objects and methodsA total of 403 cases of endometriosis treated in our hospital from January 2006 to January 2016 were retrospectively analyzed.According to the different treatment methods,divided into the control group and observation group,in which the control group of patients taking laparoscopic surgery,a total of 200 cases;observation group of patients in the implementation of laparoscopic surgery on the basis of internal dissipation for treatment,203 cases.Observation of the two groups of patients with surgical results,that is,postoperative pain relief rate,ectopic disease recurrence rate,pregnancy rate of infertility patients,biochemical indicators CA125 and so on.A one-year follow-up was conducted in the form of telephone or outpatient referral,and the clinical data of the patients were compared and analyzed.The results and influencing factors were analyzed.1.The average age of the control group was(29.98 ± 4.60)years,the average infertility history was(3.60 ± 2.85)years,the average menstrual cycle was(31.09 ± 3.55)days;the average age of the observation group was(30.60 ± 4.40)Pregnancy history(3.05± 2.78)years,the average menstrual cycle(30.12 ± 4.56)days.There was no significant difference in age,infertility history and menstrual cycle between the two groups(P> 0.05).2.There were 127 cases(63.64%)and 73 cases(36.36%)in the patients with stage ?operation.The patients in the observation group had 124 patients with stage ?,the percent age was 60.87% There were 79 cases with a percentage of 39.13%.There was no significant difference between the two groups in the operation stage,the difference was not statistically significant(P> 0.05),comparable.3.There were 101 cases(49.8%)of patients with lower abdominal pain,104 cases(51.4%)of patients with sexual intercourse,99 cases(48.9%)of lumbosacral discomfort,170 cases of dysmenorrhea patients,(53.0%),106 cases(53.0%)of patients with lumbosacral malformations,106 cases(53.0%)of patients with lumbosacral malformations,,164 patients with dysmenorrhea(82.0%),anal swelling in 131 patients(65.2%).There were no statistically significant differences between the two groups before treatment(P> 0.05)Results1.There were 83 patients in the control group and 83 patients in the treatment group.There were 85 cases of patients with sexual intercourse with 0 points,95 cases of patients with treatment,95 cases of patients after treatment,0 cases of patients with lumbosacral discomfort 77 cases of patients after treatment;64 patients with dysmenorrhea score of 0patients,114 patients after treatment;patients with anorexia bulge was 0 patients with 86 cases,94 patients after treatment;observation group before treatment of the lower abdomen Pain patients were divided into 0 patients with 76 cases,100 patients after treatment;sexual intercourse pain score of 0 patients in 78 cases,101 patients after treatment;lumbosacral hypothyroidism is divided into 0 patients with 43 cases,after treatment for patients with 80 There were 61 patients with dysmenorrhea score of 0patients and 140 patients after treatment.There were 86 patients with anorectal swelling score of 0 patients and 97 patients after treatment.The difference was statistically significant(P < 0.05).2.The natural conception rates were 38.9%,45.4%,42.2% and 40.3% respectively in the observation group at 3,6,9 and 12 months respectively.The conception rates of assisted reproductive rates were 41.3%,48.9%,45.3% and 42.1 %;The natural conception rates were 25.4%,35.5%,33% and 30.1% at 3,6,9 and 12 months after operation respectively.The rates of conception were 33.3%,40% 0,36.4% and 35.3% respectively.There was significant difference between the control group and the observation group(P <0.05).The natural pregnancy rate and the assisted reproductive rate were significantly different(P <0.05).3.The CA-125 content in the control group was(55.60 ± 48.40)U / ml,the CA-125 content was(35.60 ± 28.39)U / ml and the CA-125 content was(28.23 ± 16.06)U / Ml,CA-125 content was(56.38 ± 47.60)U / ml,CA-125 content in the observation group was(36.98 ± 27.49)U / ml,Ml,CA-125 content was(26.50 ± 17.60)U / ml,CA-125 content was(41.17 ± 16.99)U / ml at 12 months after operation.The final level of the observation group was slightly lower than that of the control group,and the difference was statistically significant(P <0.05).4.There were 5 cases(2.5%)in 5 months after operation and 15 cases(7.5%)in 6months after operation,30 cases(15%)of recurrence after 1 year and cumulative recurrence rate of 25%(P <0.05%).There were 1 cases(0.5%)in the observation group and 2 cases(1.0%)in 6 months after operation.There were 21 patients(10.3%)withrecurrence rate and 12.0 %.The recurrence rate of the two groups increased with the increase of time,the observation with the same group was lower than the control group,and compared period,the observation group was less than the control group.The difference was statistically significant(P <0.05).5.The course of the patient(years),a history of pelvic surgery,body mass index(kg / m2),preoperative gestational age,preoperative birth of endometriosis The incidence of recurrence was not significant,the difference was not statistically significant(P> 0.05).Patientswith postoperative medication,r-AFS staging of endometriosis recurrence of a greater impact,the difference was statistically significant(P <0.05).ConclusionLaparoscopic surgery combined with internal dissipation can effectively relieve the pain symptoms of patients with endometriosis,to a certain extent,control the elevation of CA-125,improve the pregnancy rate,reduce the operation post recurrence rate. |
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