The Observation Of335Cases Of Endometriosis Disease Treatment Effect

Objective:To study the related factors on endometriosis disease and observe the effect of different therapeutic methods of endometriosis.Methods:335cases of patients with endometriosis disease which were diagnosed through surgery and pathology from January2008to December2010in maternal and child health hospital of Lanzhou were divided into four groups:simplex chocolate cyst of ovary, chocolate cyst of ovary with other gynecological disease, simplex adenomyosis and adenomyosis with other gynecological disease. To analyze the common related factors of the disease, such as age, occupation, the level of education, clinical manifestation and reproductive history and observe the effect of different therapeutic methods of endometriosis.Results:The ages and the level of education of four groups patients were compared, the differences were statistically significant (P<0.05). Based on clinical manifestations,166patients with abdominal pain which occupied49.55%in the335cases of patients, and compared the proportion of patients with abdominal pain in the four groups, the difference was not statistically significant (P<0.05). However, for the bloody issue, abdominal wall mass and menstrual disorder, the differences were statistically significant (P>0.05). In addition, the occupation, the times of abortion and the history of caesarean section were not statistically significant.(1)For the patients with ovarian endometriosis (simple ovarian chocolate cyst and chocolate cyst of ovary with other gynecological diseases, laparoscopic minimally invasive operation was carried out. The total cost of laparoscopic oophorocystectomy was higher than Lamp adnexectomy. But most of the patients with simple ovarian chocolate cyst chose the laparoscopic oophorocystectomy. Compared the laparoscopic oophorocystectomy with Lamp adnexectomy, the satisficing was statistically significant3months after the operation but not for6months.95.74%of the patients who with abdominal pain and100%of the patients who with abdominal wall mass whose clinical manifestations were much improved. After6months the rate retained53.19%and83.33%separately. Most of the patients of chocolate cyst of ovary with other gynecological diseases chose the laparoscopic oophorocystectomy, but there were3patients chose the total abdominal hysterectomy. Compared satisficing and clinical manifestation, the three treatments laparoscopic oophorocystectomy, Lamp adnexectomy and total abdominal hysterectomy) were not statistically significant.(2)As for the patients with simple adenomyosis, most of them adopted hysterectomy such as vaginal hysterectomy and laparoscopic intrafascial supracervical hysterectomy. And the satisficing were higher. Similarly, hysterectomy was also selected by the most patients with adenomyosis associated with other gynecological diseases. In terms of the medical expense of the patients with simplex adenomyosis, hysterectomy is more economical than Lamp medical cyst resection. However, the patients who adopted hysterectomy need to be in hospital for longer time. Only5patients adopted hystreroscope. Non-operation was adopted by5patients, whose total cost was the lowest and the average hospitalization days was relatively shorter. For the patients with simplex adenomyosis, the clinical manifestation of keeping womb and the hysterectomy were much improved after3months. The satisficing was not statistically significant after3months but after6months the difference was statistically significant.Conclusions:335cases of endometriosis disease concentrated in the age of child-bearing period. Patients with simplex chocolate cyst of ovary and chocolate cyst of ovary with other gynecological disease distributed from30to39. Patients with simplex endometriosis and endometriosis with other gynecological disease distributed from40to49. The kinds of this disease had no obvious relationship with the times of abortion and occupation. The percentage of patients who have a history of abortion in adenomyosis patients is higher than in the patients with endometriosis. Four kinds of patients mostly have abdominal pain, including for the patients with chocolate cyst of ovary, abdominal mass was the main reason for going to a doctor, but, for the patients with adenomyosis, the main clinical manifestations is bleeding and menstrual disorder. Most of the patients have chosen the laparoscopic minimally invasive operation, and postoperative satisficing is higher. Treatment of laparoscopic oophorocystectomy gets less effect and costs more than adnexectomy, but it retains the ovarian for young women and avoids the premature ovarian function decline; laparoscopic Lamp medical cyst resection in operation time and cost is slightly higher than all kinds of hysterectomy operation, but it retains the uterus, and it has the characteristics such as small wound, fast recovery, shortens hospital time, so it was accepted by most patients. Our suggestion is that we should try to avoid radical surgical treatment and combine with drug therapy to relieve the pain, prevent recurrence and improve the quality of life.