ABSTRACT
Objective To observe the effect of laparoscopic operation( LPS) for the treatment of endometrio-sis(EMS) infertile serum matrix metalloproteinase in patients of matrix metalloproteinases-9(MMP-9),tissue inhibi-tors of metalloproteinase-1(TIMP-1) and interleukin-2 (IL-2),interleukin-10(IL-10) .Methods 80 patients with EMS in 2012 August to 2013 August to accept the choice of operation cases,according to the different operation modes for the observation group(received LPS operation therapy) and control group(received open operation treatment), 40 cases in each group.The changes of serum MMP9, TIMP-1, MMP-9/TIMP-1 and IL-2, IL-10, IL-2/IL-10 and 6 months after operation in the two groups were observed before and after treatment,the pregnancy situation were ob-served.Results The MMP-9 levels of the patients in the observation group[(51.21 ±24.01)μg/L] than before treatment[(261.88 ±190.11)μg/L] decreased significantly,and the observation group decreased more obviously than that in the control group;the observation group the level of TIMP-1[ (45.88 ±11.02)μg/L] than in the control group[(25.32 ±6.67)μg/L]increased significantly (t =4.846,P <0.05);observation group MMP-9/TIMP-1 decreased significantly compared with the control group,the difference was statistically significant ( t=3.636,P<0.05);the two group after treatment,IL-2,IL-10,IL-2/IL-10,the difference was statistically significant ( t=4.228, 4.415,3.396,all P<0.05);the observation group the pregnancy rate was 65%,the abortion rate 7.7%,30.0%and the 33.3%was better than that of the control group (χ2 =9.825,4.060,all P<0.05).Conclusion LPS is an effective method in treating EMS,which can increase the serum TIMP-1 and IL-2 levels,reduce MMP9 and IL-10 level;improve the immune index,improve the patient's fertility.
ABSTRACT
Objective To explore the clinical characteristics and management of urinary tract injuries incidental in gynecologic surgery. Methods Urinary tract injuries in gynecologic surgery during the past 10 years were reviewed retrospectively.The clinical features of initial operations including the types of disease,operative procedures and the methods of diagnosis and treatment was studied. Results 21 urological injuries were incurred during the performance of 6075 gynecologic surgical procedures,an incidence of 0.35% including of 10 ureter injuries and 11 bladder injuries with incidence of 0.16% and 0.18% respectively. The time of diagnosis from 0 to 23 days postoperatively.As for operation way,Laparoscopic surgery 10 cases(48%),radical surgery for cancer 7 cases(33%),other surgery 4 cases.injury of urinary tract was found intraoperatively in 15 patients(67%) and postoperatively in 7 patients(33%).Urinary fistulae occurred in 6 patients(29%).Urinary tract injuries were mainly diagnosed methylene blue infusion,via excretory urogram(IVP),CTU.An appropriate repair during operation,putting the doubleJ-catheter and catheterization was useful. Conclusion The rate of urinary tract injury is increased as more patients received laparoscopic surgery.Most of urinary tract injuries in gynecologic surgery had optimal results when they were diagnosed early and managed correctly.