腹腔镜诊断在慢性盆腔疼痛中的作用

Jwan Abid, Israa Abid Al-Karim, W. Rajab
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摘要

慢性盆腔疼痛是妇科门诊最常见的症状之一,占妇科门诊患者的10%。本研究旨在探讨腹腔镜在评估CPP中的作用及其与临床检查和阴道超声检查的相关性。本前瞻性研究于2020年4月1日至8月31日在提克里特市Salah Al-Deen综合医院妇产科进行。研究样本由30例慢性盆腔疼痛患者组成,根据ACOG标准,采用方便的抽样方法。数据收集通过:设计封闭式开放式问卷、体格检查、经阴道超声及腹腔镜检查对30例慢性盆腔疼痛进行评估。经腹腔镜检查(90%)患者有阳性发现,盆腔检查(89%)正确识别。腹腔镜检查阴性者占10%,盆腔检查阴性者占33.3%,阴性者有67%漏诊,阳性者有11.1%漏诊,两者有统计学意义。TVS的灵敏度为85%,而盆腔检查为89%。TVS和盆腔检查的特异性分别为(100%)、(33%)。TVS和盆腔检查的准确率分别为87%和83%。在90%的抱怨不明原因CPP的妇女中,探查腹腔镜提供了明确的诊断。这些病变的手术治疗改善了70%妇女的疼痛症状。
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The Role of Diagnostic Laparoscopy in Chronic Pelvic Pain
One of the commonest symptomatology in gynecological outpatient clinics is chronic pelvic pain, it accounts for 10% of gynecologist’s general clinics patients. The study aimed to To evaluate the role of laparoscopy in evaluation of CPP, and its correlation with clinical examination and vaginal ultrasound examination. The present prospective study was done in the Department of Obstetrics and Gynecology Salah Al-Deen general hospital in Tikrit city from 1stApril- 31st August 2020. The study sample consists of 30 patients with chronic pelvic pain, according to the ACOG criteria, with a convenient sampling method. The data collection done through: a designed closed and open-ended questionnaire, physical examination, transvaginal ultrasound & laparoscopic examination for the 30 patients for evaluation of chronic pelvic pain. By laparoscopic examination (90%) of patients had positive findings, pelvic examination identified (89%) of them correctly. Those with negative findings in laparoscopy was (10%) of patient, (33.3%) of them were diagnosed as negative by pelvic examination, there were miss diagnosis in (67%) of the negative patient and (11.1%) of positive diagnosed patient, this was a statically significant relation. Sensitivity of TVS was 85%, versus 89% for the pelvic examination. Specificity for TVS, and pelvic examination was (100%), (33%) respectively. Accuracy of the test for TVS, and pelvic examination was (87%), (83%) respectively. Exploratory laparoscopy provides a definitive diagnosis in 90% of women complaining of unexplained CPP. The surgical treatment of these lesions improves painful symptomatology in 70% of women.
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