输尿管子宫内膜异位症(附七例报告)  

Diagnosis and treatment of ureteral endometriosis (a report of 7 cases)

作　　者：刘春[1] 

机构地区：[1]福建医科大学临床医学院,福建省立医院泌尿外科,福州350001

出　　处：《临床外科杂志》2007年第10期697-698,共2页Journal of Clinical Surgery

摘　　要：目的探讨输尿管子宫内膜异位症的诊断和治疗方法,提高输尿管子宫内膜异位症的诊治水平。方法回顾性分析7例输尿管子宫内膜异位症的临床诊治资料。左侧4例,右侧2例,双侧1例,B超检查均发现输尿管中上段扩张、肾积水。IVU检查7例,提示输尿管下段狭窄、输尿管上段扩张、肾积水4例,不显影3例。结果7例均行手术治疗,1例切除盆腔包块、松解输尿管并内置双J管,5例行输尿管狭窄段切除及输尿管膀胱再吻合,1例行输尿管狭窄段切除及输尿管端端吻合。术后病理检查均证实为输尿管子宫内膜异位症。随访7例,随访时间10个月至22年,症状均消失,定期复查B超及IVU,肾积水均缓解。结论输尿管子宫内膜异位症缺乏典型临床表现,治疗上应尽早解除梗阻,保护肾功能,同时治疗盆腔子宫内膜异位症。Objective To study and improve the diagnosis and treatment of ureteric endometriosis. Methods The clinical data of 7 cases of ureteric endometriosis were retrospectively analyzed. Their mean age was 40 years （range, 32- 45 years）. Of the 7 cases, 4 cases were on the left side, 2 on the right,and 1 on the bilateral. All the cases were subjected to ultrasound and intravenous urogram （IVU） as preoperative diagnosis. B - ultrasound indicated upper urinary tract dilation and hydrops in all cases,and IVU showed poor image in 3cases and upper urinary tract dilation and hydrops in 4. All the cases were treated surgically. One was treated with operation of resecting pelvic cavity masses and lysis of adhesions of ureter, and was detained with Double - J stent. Among the 6 cases with resection of ureteropathy affection, 1 was treated with end- to- end ureteroureterostomy, and 5 with ureterovesieostomy. Results Pathological findings confirmed the diagnosis of ureteral endometriosis. During the fol- low- up period of 10 months to 22 years for 7 cases,all symptoms were vanished. All cases were subjected to regular B- ultrasound and IVU. Nephrohydrosis was improved. Conclusion Ureteral endometriosis was lack of typically clinical manifestation. Therapeutic principle is to relief obstruction of ureter and treat pelvic endometriosis. If diagnosis and treatment can be done punctually, nephrohydrosis of most patients can be released.

关 键 词：子宫内膜异位症 输尿管 

分 类 号：R711.71[医药卫生—妇产科学] R693[医药卫生—临床医学]