会阴子宫内膜异位症30例临床分析

目的探讨会阴子宫内膜异位症的临床诊断及治疗。方法对30例会阴子宫内膜异位症（简称内异症）病例进行回顾性分析,术后随诊0．5—13年。结果会阴内异症占院内同期内异症的0．32％,阴道分娩发生会阴内异症为0．0065％,发病潜伏期为4个月至13年。会阴内异症均表现为会阴伤口的周期性、痛性结节,CA125值无明显升高,病灶完整切除者可达到治愈。5例（16．7％）患者合并盆腔内异症。结论根据典型的病史和体格检查可做出正确的诊断,会阴内异症可合并盆腔内异症存在,手术切除是主要的治疗方法,未累及肛门括约肌的患者由于手术可完整切除,复发率低于累及肛门括约肌的病例,是否累及肛门括约肌的术前评价至关重要。

Clinical analysis of 30 patients with perineal endometriosis

OBJECTIVE: To investigate the diagnosis and treatment of perineal endometriosis. METHODS: The clinical date of 30 patients with perineal endometriosis, aged 32.3 (23 approximately 44), who were admitted 1983 - 2006, operated on, and followed up for 0.5 approximately 13 years, were analyzed. RESULTS: The incidence of perineal endometriosis was 0.32% among the total endometriosis cases. Five of these 30 patients (16.7%) suffered from perineal endometriosis combined with pelvic endometriosis. The latent period was 4 months to 13 years. There was no significant difference in onset of age. All patients had cyclical and painful lesions. The level of CA125 was normal. All patients were cured after complete surgical excision. CONCLUSION: Diagnosis of perineal endometriosis can be made based on the patients' history and clinical manifestations. Surgical excision is the first choice of treatment. The recurrent rate of the cases without anal sphincter involvement is lower than that with anal sphincter invasion since the complete incision can be made. It is important to evaluate pre-operatively if the anal sphincter is involved.