目的：探讨腹腔镜下卵巢子宫内膜异位囊肿保守手术的疗效。方法:2005年1月至2006年7月间采用腹腔镜保守手术治疗卵巢子宫内膜异位囊肿患者106例。患者平均年龄（32.5±6.4）岁，平均病程2.1年。合并不孕症21例，痛经54例，性交痛38例，慢性盆腔痛76例。无明显自觉症状仅以普查发现附件肿物者23例。结果：106例患者中行囊肿剔除术100例（94.3％），其中单侧卵巢内膜异位囊肿剔除61例，双侧卵巢内膜异位囊肿剔除39例（其中双侧囊肿剔除术34例，一侧囊肿剔除而另一侧附件切除5例），单侧附件切除6例。所有患者平均手术时间(38±11)分钟，平均出血量（35.6±12.5）mL。首次排气时间平均在术后（22.3±4.2）小时。平均住院天数（4.2±1.3）天。随访3～18个月，除21例不孕患者均于术后服用内美通或孕三烯酮2.5 mg 2次/周共3～6个月。106例患者中治疗性交痛总有效率92.2％，治疗慢性盆腔痛总有效率92.1％，治疗痛经总有效率90.7％。21例不孕患者中总妊娠率61.9％，7例(53.8％)半年内妊娠，6例（46.2％）1年内妊娠。术后复发9例（8.5％）。结论:对保留生育功能的卵巢子宫内膜异位囊肿患者，腹腔镜下保守手术是目前公认的安全、有效的手术方法。
ObjectiveTo systematically review the influence on ovarian reserve function by different hemostatic methods during laparoscopic cystectomy in treatment of ovarian endometrioma (OE). MethodsDatabases including The Cochrane Library, PubMed, EMbase, CNKI, CBM and WanFang Data were electronically searched, to collect relevant randomized controlled trials (RCTs) about laparoscopic electro coagulation vs. microscopically suture for OE from 1990 to Mar, 2014. Meanwhile, references of included studies were also retrieved manually. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and assessed the risk of bias of included studies. Then RevMan 5.2 software was used for meta-analysis. ResultsA total of 16 RCTs involving 1 236 patients were finally included. The results of meta-analysis showed that the luteinizing hormone (LH) levels after 1 month, 2 months, 6 months and 12 months and estradiol (E2) levels after 2 months, 6 months had no significant differences between the two groups and the E2 level after 12 month of the suture group was significantly lower than that of the electro coagulation group. The levels of follicle stimulating hormone (FSH), LH, E2, antral follicle count (AFC), mean ovarian stromal peak systolic blood flow velocity (PSV) and anti-Mullerian hormone (AMH) in the suture group were significantly superior to those in the electro coagulation group at other follow-up time. ConclusionCurrent evidence suggests that in treatment of ovarian endometriotic cyst by laparoscopic cystectomy, compared with electro coagulation hemostasis, suture hemostasis has less influence on ovarian reserve function. Due to limited quality and quantity of included studies, more high quality studies are needed to verify the above conclusion.