盆腔外子宫内膜异位症19例临床分析

目的 探讨盆腔外子宫内膜异位症的临床特征。方法收集本院1990年1月至2000年12月收治的19例盆腔外子宫内膜异位症患者的临床资料,分析其发病情况、临床表现、诊断、治疗及预后。结果 18例患者为育龄期妇女,1例为围绝经期妇女,平均年龄36.2岁。病变部位8例位于手术切口、宫颈及阴道穹隆6例、胃肠道2例、泌尿系统3例及其他部位1例。主要症状:8例有皮下结节伴经期疼痛、2例月经期血尿及排便痛等,5例无典型症状。术前诊断率较低(52.6％)。治疗以局部病灶切除为主,术后辅以药物治疗。结论盆腔外子宫内膜异位症原因较复杂,因临床表现不典型,术前诊断率不高,应注意原发症状与月经周期的关系,提高对本病的认识。治疗应以切除病灶、缓解症状、恢复功能为主。

Clinical analysis of extrapelvic endometriosis in 19 cases

Objective To study the clinical features of extrapelvic endometriosis.Methods 19 cases of extrapelvic endometriosis between Jan. 1990 to Dec.2000 admitted in Peking Uniseisity People ' s hospital were reviewed. The incidence , clinical presentation, diagnosis , treatment and prognosis were analyzed retrospectively. Results Most patients were in sexual maturity and the mean age was 36.2 yrs. The of the lesions were varied, including 8 cases of abdominal incision, 6 cases of cervical and vaginal fomices, 2 cases of sites gastrointestinal tract, 3 cases of urinary system and 1 case in other region. The main symptoms included subcutaneous nodules with pain during menses, hematuria and difficulty in defecation related with menses et al. 5 cases had no typical symptoms. The accuracy of preoperation diagnosis was just 52.6%. Surgical resection of the lesions was the main treatment option assisted with medical treatment postoperative. Conclusions The causes of the extrapelvic endometriosis were comprehensive and the clinical presentations were atypical. So it is difficult to diagnose before operations.The relationship between original symptoms and menses should be emphasized and the knowledge of this disease should be strengthened. Principles of management include resection the regional lesions, relief of symptoms and to recovery functions.