盆腔炎性疾病误诊为子宫内膜异位症29例临床分析

目的探讨不同临床指标在鉴别盆腔炎性疾病（PID）后遗症与盆腔子宫内膜异位症（EM）中的作用。方法回顾性分析29例临床误诊为子宫内膜异位症的盆腔炎性疾病后遗症患者的临床资料，并以同期72例子宫内膜异位症患者为对照，单变量和多变量分析不同临床指标在鉴别诊断中的作用。结果无继发痛经、无性交痛、无骶韧带痛性结节、慢性腹痛和初潮年龄≥14岁诊断PID的敏感性分别为72．4％、96．6％、86．2％、65．5％和69．O％，特异性分别为58．3％、20．8％、59．7％、62．5％和54．2％。组合指标中，敏感性较高的为无继发痛经或无性交痛、无骶韧带痛性结节或无性交痛、慢性腹痛或无性交痛、初潮年龄≥14岁或无性交痛、慢性腹痛或无骶韧带痛性结节，其敏感性分别为100％、100Voo、96．6％、96．6％和96．3％；特异性较高的组合指标有慢性腹痛和无骶韧带痛性结节、慢性腹痛和无继发性痛经、慢性腹痛和初潮年龄≥14岁，其特异性为88．9％、86．1％和83．3％。多变量分析慢性盆腔痛、初潮年龄和骶韧带痛性结节3项指标选人了最终方程，回归方程式为：子宫内膜异位症的可能性=1／[-1＋e-（591-1.75×慢性盆腔痛 有/无-0.355×初潮年龄＋2.482×骶韧带痛性结节 有/无]，以0．5为判别分界点，公式的准确率为82．3％。结论规范的临床检查有助于减少子宫内膜异位症的误诊。

Clinical analysis of 29 cases of misdiagnosed endometriosis

Objective To investigate the clinical methods of differential diagnosis between pelvic inflammatory disease (PID) and endometriosis (EM).Methods The clinical data of 29 cases of PID who were misdiagnosed as EM and 72 cases of EM were analyzed retrospectively.Results The sensitivity for symptoms such as non-secondum dysmenorrhea,non-dyspareunia,non-tenderness nodules at uterosacral ligament,chronic pelvic pain and menarche age older than 14 years to diagnose PID were 72.4%,96.6%,86.2%,65.5% and 69.0%,respect...