直肠子宫内膜异位症的诊断和手术治疗  

The diagnosis and surgical treatment in rectal endometriosis

作　　者：刘福坤[1] 周珊英[1] 苏延华[1] 顾秋善[1] 李国立[1] 

机构地区：[1]解放军南京军区总医院全军普外研究所

出　　处：《中华外科杂志》1997年第3期170-172,共3页Chinese Journal of Surgery

摘　　要：作者报告了２６例直肠子宫内膜异位症的诊断和手术治疗的经验。该病在临床症状、体征等方面易与直肠癌相混淆，易引起误诊和误治，但在病史上有其特点，即直肠刺激征、胀痛或便血，常在月经前后加重。便血在月经期多见。直肠指检和妇科检查，直肠触及的肿块多位于粘膜下，与阴道壁和宫颈粘连。直肠镜检查直肠粘膜病变较轻，仅为充血糜烂或息肉状隆起。组织病理学检查为慢性炎症表现。手术适应证为保守治疗无效、症状明显、影响正常生活者；病灶小者行局部肠壁楔形切除，病灶大而深，位置低者可以行前切除吻合术。本组局部切除１６例，前切除吻合术１０例。术后症状消失者２１例，症状改善者５例。２例５年后症状复发，行再次手术后恢复。From Jun 1975 to Mar 1995,26 cases of endometriosis in the rectum(RE) were admitted.Local rsection was performed in 16 and Dixon's operation in 10.The result showed 21 cases were symptomatically cured and 5 with remission. 2 cases were reoperated because of recurrence in 5 years after the first operation and cured. RE is difficult in distiguishing from rectal cancer.It is characterized by tenesmus,bursting pain,hematochezia in young and middle aged women during periods.The diagnosis can be made by tipycal history and vaginal examination,rectal examination,barium enema, proctoscopy and so on.The indications of operation include severe clinic symptoms and failed conservative therapy.Wedge resection was suitable in cases with small lession in rectum,while large, deep seated lessions in lower rectum were treated with Dixon's operation in order to prevent recurrence.

关 键 词：子宫内膜异位症 直肠 诊断.外科手术 

分 类 号：R711.710.5[医药卫生—妇产科学]