en ارزیابی اثرات جراحی لاپاروسکوپی بر شدت درد و کیفیت زندگی در زیرگروه‌های مختلف اندومتریوزیس: یک مطالعه پیگیری Pregnancy Health Original Article Original Article <div style="text-align: justify;"><span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مقدمه: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مطالعات نشان داده‌اند که اندومتریوز به طور قابل‌توجهی تأثیر منفی بر سلامت روانی و کیفیت زندگی زنان دارد و باعث می‌شود که کیفیت زندگی کمتری را تجربه کنند.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">هدف: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">این مطالعه با هدف بررسی تأثیر جراحی لاپاروسکوپی بر شدت درد و کیفیت زندگی زنان مبتلا به انواع مختلف اندومتریوز انجام شده است.</span></span><b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif""></span></span></b></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مواد و روش &shy;ها: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">در این مطالعه پیگیری، 50 زن مبتلا به اندومتریوز که تحت جراحی لاپاروسکوپی قرار گرفته بودند، شرکت کردند. این افراد دارای نمره بالای آنالوگ بصری</span></span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">(6 </span></span><span lang="FA" style="font-size:10.0pt"><</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) همراه با کیفیت زندگی پایین، عدم پاسخ به درمان دارویی، ناباروری همراه با درد مقاوم به درمان‌های کمک‌باروری، و درگیری سایر ارگان‌ها مانند روده یا حالب بودند. این افراد در بیمارستان امیرالمومنین زابل، ایران، از مرداد 1401 تا دی 1401 تحت درمان قرار گرفتند. شرکت‌کنندگان به دو گروه تقسیم شدند: افراد مبتلا به اندومتریوز درجه </span></span><span dir="LTR" style="font-size:10.0pt">IV</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> و افرادی با درجات پایین‌تر (</span></span><span dir="LTR" style="font-size:10.0pt">I-III</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">). نمره درد با استفاده از مقیاس آنالوگ بصری و کیفیت زندگی شرکت‌کنندگان با استفاده از پرسشنامه سلامت اندومتریوز اندازه‌گیری شد.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتایج: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">میانگین سنی شرکت</span></span><span lang="FA" style="font-size:11.0pt"><span cambria="" style="font-family:">&shy;</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">کنندگان 6/8 </span></span><span lang="FA" style="font-size:10.0pt">&plusmn;</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> 32 سال بود. شرکت</span></span><span lang="FA" style="font-size:11.0pt"><span cambria="" style="font-family:">&shy;</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">کنندگان بر اساس انجمن پزشکی تولید</span></span><span lang="FA" style="font-size:11.0pt"><span cambria="" style="font-family:">&shy;</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مثل آمریکا به دو گروه تقسیم شدند: شرکت</span></span><span lang="FA" style="font-size:11.0pt"><span cambria="" style="font-family:">&shy;</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">کنندگان با اندومتریوز درجه </span></span><span dir="LTR" style="font-size:10.0pt">IV</span><span style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> (1/55%) و شرکت</span></span><span lang="FA" style="font-size:11.0pt"><span cambria="" style="font-family:">&shy;</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">کنندگان با درجه کمتر از </span></span><span dir="LTR" style="font-size:10.0pt">IV</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">. میانگین نمرات شدت درد و کیفیت زندگی در زنان در هر دو گروه طی 12 ماه به طور معنی&shy;داری کاهش یافت (0001/0 </span></span><span lang="FA" style="font-size:10.0pt">></span> <span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) اما میانگین تغییرات درد و نمرات کیفیت زندگی در شرکت</span></span><span lang="FA" style="font-size:11.0pt"><span cambria="" style="font-family:">&shy;</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">کنندگان دو گروه از نظر آماری تفاوت معنی</span></span><span lang="FA" style="font-size:11.0pt"><span cambria="" style="font-family:">&shy;</span></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">داری مشاهده نشد (به ترتیب 520/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> و 984/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">).</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتیجه&shy; گیری: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">درمان لاپاراسکوپی می‌تواند باعث کاهش درد و امتیاز کیفیت زندگی (افزایش شاخص‌های کیفیت زندگی) در زنان مبتلا به آندومتریوز بدون در نظر گرفتن شدت بیماری شود.</span></span><b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif""></span></span></b></span></span></span></span></span></div> <div style="text-align: justify;"><span style="font-family:Times New Roman;"><span style="font-size:11pt"><span style="line-height:normal"><span sans-serif=""><b><span style="font-size:12.0pt"><span new="" roman="" times="">Background:</span></span></b><span style="font-size:12.0pt"><span new="" roman="" times=""> Studies have shown that endometriosis significantly has a negative impact on women&#39;s mental health and quality of life (QoL), resulting in these participants experiencing a diminished QoL. </span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span sans-serif=""><b><span style="font-size:12.0pt"><span new="" roman="" times="">Objective: </span></span></b><span style="font-size:12.0pt"><span new="" roman="" times="">This study aimed to evaluate the effect of laparoscopic surgery on the severity of pain and the QoL of women with different types of endometriosis.</span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span sans-serif=""><b><span style="font-size:12.0pt"><span new="" roman="" times="">Materials and Methods:</span></span></b><span style="font-size:12.0pt"><span new="" roman="" times=""> In this follow-up study 50 women with endometriosis, who underwent laparoscopic surgery, who met a high visual analog score (> 6) with impaired QoL, lack of response to analgesics, infertility with pain unresponsive to assisted reproductive therapy, and involvement of other organs such as the bowel or ureter at the Amir Al Momenin hospital, Zabol, Iran, from August 2022 to January 2023 were enrolled. The participants were categorized into 2 groups: those with stage IV endometriosis and those with lower stages (I-III). Groups according to the higher occurrence of grade 4 endometriosis, as 55.1% were affected by it. The pain score was measured using the visual analog score, and the participants&rsquo; QoL score was measured using the endometriosis health profile questionnaire. </span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span sans-serif=""><b><span style="font-size:12.0pt"><span new="" roman="" times="">Results:</span></span></b><span style="font-size:12.0pt"><span new="" roman="" times=""> The mean age of participants was 32 yr, with a standard deviation of 8.6 yr. Participants were divided into 2 groups: those with grade 4 endometriosis (55.1%) and those with a grade lower than 4, as classified by the American Society for Reproductive Medicine. Over 12 months, both groups experienced a significant decrease in pain severity and QoL scores (p < 0.0001). However, the changes in pain and QoL scores between the 2 groups were not statistically significant (p = 0.520 and p = 0.984, respectively).</span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span sans-serif=""><b><span style="font-size:12.0pt"><span new="" roman="" times="">Conclusion:</span></span></b><span style="font-size:12.0pt"><span new="" roman="" times=""> Laparoscopic treatment can reduce pain and QoL scores (increase the QoL indices) in women with endometriosis, regardless of the disease&rsquo;s severity.</span></span></span></span></span></span></div> <br> <span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif"></span></span></span></span></span> آندومتریوز, لاپاراسکوپی, درد, کیفیت زندگی. Endometriosis, Laparoscopy, Pain, Quality of Life. 199 206 http://ijrm.ir/browse.php?a_code=A-10-2764-1&slc_lang=en&sid=1 Mania Kaveh maniakaveh@gmail.Com 0000-0001-5012-6937 No Department of Obstetrics and Gynecology, School of Medicine, Amir Al Momenin Hospital, Zabol University of Medical Sciences, Zabol, Iran. Haniye Malakouti h.mlk1209@gmail.com 0009-0004-9013-0112 No School of Medicine, Zabol University of Medical Sciences, Zabol, Iran. Shahla Chaichian shchaichian@gmail.com 0000-0001-5772-8711 No Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran. Abolfazl Mehdizadeh Kashi mehdizadehkashi@iums.ac.ir 0000-0002-0471-5463 No Iranian Scientific Society of Minimally Invasive Gynecology, Tehran, Iran. Mahdi Afshari mehdiafshari16@yahoo.com 0000-0002-3159-8741 No Department of Community Medicine, School of Medicine, Pediatric Gastroenterology and Hepatology Research Center, Zabol University of Medical Sciences, Zabol, Iran. Kambiz Sadegi Kamsadegi@yahoo.co.uk 0000-0002-0221-5799 Yes Department of Anesthesiology, School of Medicine, Amir Al Momenin Hospital, Zabol University of Medical Sciences, Zabol, Iran.