子宫内膜异位症患者疼痛与盆腔病灶特征的相关性

目的探讨子宫内膜异位症(EMs)患者盆腔病灶特征与疼痛的相关性。方法选择经腹腔镜、病理检查确诊的子宫内膜异位症患者300例,详细记录子宫内膜异位症患者盆腔疼痛症状包括痛经、性交痛、肛门坠胀痛及排便痛、慢性盆腔痛(CPP)发生情况,回顾分析并评价盆腔疼痛症状与内异症患者病灶特征的关系。结果盆腔疼痛与内异症病灶类型、部位、分期、浸润程度、盆腔粘连程度呈相关性。结论痛经、性交痛、肛门坠胀痛及排便痛、CPP与盆腔内异症病灶的部位和浸润深度有关,位于盆腔后部的深部浸润病灶以及子宫直肠窝封闭与疼痛症状关系密切,深部宫骶韧带病灶与CPP密切相关;排便痛与宫骶韧带病灶、阴道直肠隔病灶和子宫直肠窝封闭有关,性交痛与阴道直肠隔病灶有直接关系。根据内异症患者的疼痛症状类型可在一定程度上预测内异症的分期及部位、浸润深度、粘连程度等,并为临床诊治提供依据。

Correlation between characteristics of pain and pelvic lesion in endometriosis patients

Objective To study the correlation between characteristics of pain and pelvic lesion in endometriosis patients.Methods Dysmenorrhea,dyspareunia,anus flatulence and defecation pain,chronic pelvic pain(CPP) of 300 patients with endometriosis diagnosed by laparoscopy and pathology were retrospectively analyzed and their correlation was assessed.Results Pelvic pain was closely related with the type,location,staging,and pelvic adhesion of endometriosis.Conclusion Dysmenorrhea,dyspareunia,anus flatulence and defecation pain,and CPP are related with the location and infiltration depth of pelvic lesion.Deep infiltration lesions at the posterior pelvis and sealed retrouterine excavation are closely related the symptoms of pain.Deep sacral ligament lesion of uterine is closely related with CPP.Defecation pain is related with sacral ligament lesion of uterine,vaginorectal septum lesion,and retrouterine excavation.Dyspareunia is directly related with vaginorectal septum lesion.The type of pain can predict the staging,location,infiltration depth and adhesion of endometriosis,thus proving evidence for its diagnosis and treatment.