肠道子宫内膜异位症28例诊治分析

目的：探讨肠道子宫内膜异位症（ BE）的临床特征、诊断及治疗方法。方法对28例BE患者的临床表现、诊断方法、治疗及预后情况进行总结分析。结果28例BE患者主要表现为痛经16例（57.1％），性交痛12例（42.9％），下腹疼痛8例（28.6％）；有22例（78.6％）合并消化系统症状，16例（57.1％）合并不孕不育。患者确诊时间3-12 d。先后经阴道超声＋直肠超声内镜检查8例，阴道超声＋螺旋CT＋直肠超声内镜10例，阴道超声＋螺旋CT＋结肠镜6例，阴道超声＋螺旋CT＋磁共振成像4例；经开腹手术治疗12例，腹腔镜手术治疗16例。所有患者治疗后症状消失，术后随访0.5-5年无复发病例。16例不孕不育症患者中，受孕10例（62.5％）。结论 BE患者临床表现不典型，诊断困难，手术或腹腔镜治疗效果显著。

Diagnosis and treatment of 28 cases with bowel endometriosis

Objective To explore the clinical manifestation,diagnosis and treatment of bowel endometriosis（BE）. Methods The clinical characters,diagnosis,treatment and outcomes of the 28 cases with BE were summarized and analyzed. Results Out of the 28 cases,16（57. 1%）mainly presented menalgia,12（42. 9%）algopareunia,8（28. 6%）lower abdominal pain,and 22 cases（78. 6%） were complicated with digestive symptoms,16（57. 1%）with sterility infertility;the diagnosis were confirmed within 3 to 12 days;the examination with per-vagina ultrasound and endorectal endoscopic ultrasonography was made in 8 cases,that with per-vagina ultrasound,multiple screw CT and endorectal endoscopic ultrasonography in 10 cases,that with per-vagina ultrasound,multiple screw CT and colonoscopy in 6 cases and that with per-vagina ultrasound,multiple screw CT and magnetic resonance imaging in 4 cases. 12 cases were treated by open abdominal surgery and 16 cases under laparoscope. After treatment,the symptoms of BE were dismissed in all cases and follow-up lasted from half a year to 5 years with no reoccurrence;out of the 16 cases complicated with sterility infertility,10 cases（62. 5%）were pregnant. Conclusions The symptoms of BE are not typical,and the diagnosis of BE is difficult;open abdomen surgery and laparoscopic treatment are effective for BE.