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腹腔镜手术能否减轻子宫内膜异位症女性的疲劳?——一项初步研究。

Can Laparoscopic Surgery Reduce Fatigue in Women with Endometriosis?-A Pilot Study.

作者信息

Reischer Theresa, Sklenar Catherine, Perricos-Hess Alexandra, Husslein Heinrich, Kuessel Lorenz, Wenzl René, Bekos Christine

机构信息

Department of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria.

出版信息

J Clin Med. 2024 May 28;13(11):3150. doi: 10.3390/jcm13113150.

Abstract

Fatigue is mentioned as one of the most significant symptoms of endometriosis. The impact of laparoscopic endometriosis surgeries on fatigue remains unknown. The aim of this study was to investigate, for the first time, the effect of laparoscopic surgery in endometriosis patients, with the complete removal of endometriotic lesions, on the severity of fatigue. This is a single-center prospective pilot study including 58 participants. Participants were recruited at the Tertiary Endometriosis Referral Center of the Medical University of Vienna between February 2020 and November 2021. Thirty patients with histologically proven endometriosis were compared to a control group of 28 patients who underwent a laparoscopy for benign gynecologic conditions other than endometriosis. All participants were interviewed using the Fatigue Severity Scale before their surgery and 6 months afterward. Relationships between variables were established using regression analysis and associations were quantified as odds ratios. Fatigue was significantly more severe preoperatively in patients with endometriosis when compared to controls ((odds ratio (OR): 1.82; 95% confidence interval (CI): 1.24-2.67, < 0.01). Six months postoperatively, the fatigue severity score of endometriosis patients decreased significantly ( < 0.01). In multivariate analysis, fatigue was significantly associated with endometriosis (OR: 4.50, CI: 1.14-17.8, < 0.05), when adjusted for abdominal pain and menstrual bleeding. Fatigue in patients with endometriosis was not associated with disease stage or the presence of deep endometriosis. Fatigue is a frequent and bothersome symptom in patients with endometriosis. Within our study, we demonstrated for the first time that fatigue responds to surgical treatment. The management of fatigue is crucial to improving patients' quality of life.

摘要

疲劳被认为是子宫内膜异位症最显著的症状之一。腹腔镜子宫内膜异位症手术对疲劳的影响尚不清楚。本研究的目的是首次调查腹腔镜手术在完全切除子宫内膜异位病变的子宫内膜异位症患者中对疲劳严重程度的影响。这是一项单中心前瞻性试点研究,包括58名参与者。参与者于2020年2月至2021年11月在维也纳医科大学三级子宫内膜异位症转诊中心招募。将30例经组织学证实为子宫内膜异位症的患者与28例因非子宫内膜异位症的良性妇科疾病接受腹腔镜检查的对照组患者进行比较。所有参与者在手术前和术后6个月使用疲劳严重程度量表进行访谈。使用回归分析建立变量之间的关系,并将关联量化为优势比。与对照组相比,子宫内膜异位症患者术前疲劳明显更严重(优势比(OR):1.82;95%置信区间(CI):1.24 - 2.67,<0.01)。术后6个月,子宫内膜异位症患者的疲劳严重程度评分显著降低(<0.01)。在多变量分析中,在调整腹痛和月经出血后,疲劳与子宫内膜异位症显著相关(OR:4.50,CI:1.14 - 17.8,<0.05)。子宫内膜异位症患者的疲劳与疾病分期或深部子宫内膜异位症的存在无关。疲劳是子宫内膜异位症患者常见且困扰人的症状。在我们的研究中,我们首次证明疲劳对手术治疗有反应。疲劳的管理对改善患者生活质量至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4023/11172980/beb719f8ce0b/jcm-13-03150-g001.jpg

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