腹腔镜检查在妇科诊断前期工作中的作用1。
The role of laparoscopy in the propaedeutics of gynecological diagnosis1.
作者信息
Argentino Gislaine Laperuta Serafim, Bueloni-Dias Flávia Neves, Leite Nilton José, Peres Gustavo Filipov, Elias Leonardo Vieira, Bortolani Vitória Cristina, Padovani Carlos Roberto, Spadoto-Dias Daniel, Dias Rogério
机构信息
Assistant Physician, Gynecological Endoscopy and Family Planning Sector, Department of Gynecology and Obstetrics, Botucatu Medical School, Universidade Estadual Paulista (UNESP), Botucatu-SP, Brazil. Conception and design of the study; acquisition, analysis and interpretation of data; technical procedures; manuscript preparation.
Clinical Assistant Professor, Department of Gynecology and Obstetrics, Botucatu Medical School, UNESP, Botucatu-SP, Brazil. Acquisition, analysis and interpretation of data; technical procedures; manuscript preparation.
出版信息
Acta Cir Bras. 2019 Feb 14;34(1):e20190010000010. doi: 10.1590/s0102-865020190010000010.
PURPOSE
To evaluate agreement between pre- and post-laparoscopy gynecological diagnosis in order to demonstrate the rationality of this minimally invasive technique use in gynecological propaedeutics.
METHODS
Retrospective chart review study conducted between March 2010 and October 2016 based on a convenience sample. 315 patients undergoing surgical laparoscopy at the Center of Gynecologic Endoscopy and Family Planning of Botucatu Medical School/UNESP. Pre- and postoperative diagnoses were compared by the diagnosis agreement test considering the proportions of events.
RESULTS
Laparoscopy contributed to diagnosis in 59.6% of infertility cases (P>0.05), in 93.7% of chronic pelvic pain of undetermined origin (P<0.01) and conclusively elucidated the diagnosis of acute abdomen and the ruling out of tubo-ovarian abcess (P<0.05). Laparoscopy also increased the diagnosis of pelvic-abdominal adhesions in 76.7% (P>0.05).
CONCLUSION
The use of laparoscopy considerably contributed to diagnostic elucidation, especially in cases of undetermined chronic pelvic pain.
目的
评估腹腔镜检查前后妇科诊断之间的一致性，以证明这种微创技术在妇科诊疗中的合理性。
方法
基于便利样本，对2010年3月至2016年10月期间进行的回顾性病历审查研究。315例患者在Botucatu医学院/圣保罗州立大学妇科内镜与计划生育中心接受手术腹腔镜检查。通过考虑事件比例的诊断一致性检验比较术前和术后诊断。
结果
腹腔镜检查对59.6%的不孕症病例诊断有帮助（P>0.05），对93.7%病因不明的慢性盆腔疼痛病例诊断有帮助（P<0.01），并最终明确了急腹症的诊断并排除了输卵管卵巢脓肿（P<0.05）。腹腔镜检查还使盆腔粘连的诊断率提高了76.7%（P>0.05）。
结论
腹腔镜检查的使用对诊断的明确有很大帮助，尤其是在病因不明的慢性盆腔疼痛病例中。
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