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目的 探讨腹腔镜手术在盆腔炎 (plevicinflammatorydisease ,PID)治疗中的价值。 方法 复旦大学附属妇产科医院于 1998年 1月至 2 0 0 3年 3月对临床诊断为急性PID患者 86例 ,分别行单纯药物治疗 ,超声下穿刺 ,药物控制感染后经腹或腹腔镜手术治疗PID。治疗后随访 6～ 12个月。结果 药物治疗及超声下穿刺者 ,与手术治疗组治疗后盆腔炎性包块和盆腔痛发生率相比差异有显著性意义 (P <0 0 1)。经腹手术与腹腔镜手术 ,手术时间差异无显著性意义 (P >0 0 5 ) ,住院天数腹腔镜手术组明显缩短 (P <0 0 5 )。所有手术病例 ,行全子宫双附件切除 (TAH BSO) 6例 ,患侧附件切除 (USO) 19例 ,保守性手术 2 7例 ,术后盆腔炎性包块分别为 0、0和 5例 (P >0 0 5 ) ;盆腔痛分别有 1、1和 6例 (P >0 0 5 ) ;但同时出现盆腔炎性包块和盆腔痛的患者TAH BSO组 1例 ,USO组 1例 (P >0 0 5 ) ,保守性手术患者 11例 ,保守性手术患者与USO组相比差异有显著性意义 (P <0 0 1)。PID病程在 1周以内者 ,腹腔镜手术时间明显短于经腹手术组 (P <0 0 5 ) ;病程超过 1周时两组手术时间差异无显著性意义 (P >0 0 5 )。结论 腹腔镜检查是诊断急性PID诊断的金标准。保守性手术术后并发症较多 ,但对女性生殖内分泌功能及生育能力
Objective To investigate the value of laparoscopic surgery in the treatment of pelvic inflammatory disease (PID). Methods Obstetrics and Gynecology Hospital of Fudan University in January 1998 to March 2003 for the clinical diagnosis of acute PID in 86 patients were treated with simple drug therapy, ultrasound puncture, drug-controlled infection after abdominal or laparoscopic Surgical treatment of PID. Follow-up 6 to 12 months after treatment. Results Drug treatment and ultrasound puncture, and surgical treatment group pelvic inflammatory mass and pelvic pain after the occurrence of the difference was significant (P <0.01). Laparoscopic surgery and laparoscopic surgery had no significant difference in operative time (P> 0.05) and laparoscopic surgery (P <0.05). In all the cases, there were 6 cases of total hysterectomy (TAH BSO), 19 cases of USO, 27 cases of conservative operation, and 0, 0 and 5 cases of pelvic inflammatory mass (P> 0.05). There were 1, 1 and 6 cases of pelvic pain respectively (P> 0.05). However, there were 1 case of TAH BSO with pelvic inflammatory mass and pelvic pain, and 1 case of USO (P > 0 0 5), conservative surgery in 11 patients, conservative surgery patients compared with the USO group was significantly different (P <0.01). The duration of laparoscopic surgery was significantly shorter than that of the abdominal surgery group (P <0 05) when the duration of PID was within 1 week. There was no significant difference in operative time between the two groups when the course of disease was over 1 week (P 0 05). Conclusion Laparoscopy is the gold standard for diagnosing acute PID. Conservative surgery more postoperative complications, but female reproductive endocrine function and fertility