复杂深部浸润型子宫内膜异位症的诊断与治疗：附1例病例报道及文献复习  

Diagnosis and treatment of complicated deep infiltrated endometriosis:A case report and literature review

作　　者：蒋国庆[1] 高雨农[1] 高敏[1] 郑虹[1] 燕鑫[1] 王文[1] 安娜[1] 曹崑[2] 孙宇[3] 

机构地区：[1]北京大学临床肿瘤学院,北京肿瘤医院暨北京市肿瘤防治研究所,妇科,北京100142 [2]北京大学临床肿瘤学院,北京肿瘤医院暨北京市肿瘤防治研究所放射科,北京100142 [3]北京大学临床肿瘤学院,北京肿瘤医院暨北京市肿瘤防治研究所病理科,北京100142

出　　处：《北京大学学报（医学版）》2011年第4期603-607,共5页Journal of Peking University:Health Sciences

摘　　要：目的:探讨深部浸润型子宫内膜异位症的诊断与治疗。方法:回顾分析1例深部浸润型子宫内膜异位症的临床诊治资料。结果:1例39岁女性,确诊复杂深部浸润型子宫内膜异位症,病变累及宫颈、两侧宫旁、子宫骶韧带、左输尿管、左卵巢、Douglas凹、直肠阴道膈及阴道,临床表现似晚期宫颈癌。患者以下腹痛、阴道不规则出血和发现宫颈肿物收入院,经宫颈锥切术和腹腔镜检查确诊,促性腺激素释放激素激动剂(GnRH-A)治疗3个月后行子宫内膜异位症根治手术和输尿管粘连松解术,有效切除病灶并缓解肾积水,术后2年随访检查未复发。结论:深部子宫内膜异位症同时累及宫颈且与宫颈恶性肿瘤难以鉴别时,应依靠组织病理学检查确诊。Objective： To explore diagnostic and therapeutic methods of patients with deep infiltrating endometriosis.Methods： Clinical data of a case of complicated deep infiltrating endometriosis were analyzed retrospectively.Results： A 39-year-old female patient with deep infiltrating endometriosis involving the cervix,bilateral parametrium,uterosacral ligaments,left ureter,left ovary,pouch of Douglas,rectovaginal septum,and vagina,presented as the advanced cervical cancer.She went through initial manifestation of hypogastralgia,irregular vaginal bleeding and left hydronephrosis.Cervical biopsy and embolism of bilateral uterine artery,cervical conization and laparoscopic approach and biopsy confirmed the diagnosis.After being treated with gosereline acetate for three months,she received a radical removal and ure-terolysis.She had no evidence of recurrence after two years＇ follow-up.Conclusion： When gynecologists make a differential diagnosis of the cervical malignancy,if the clinical manifestations are inconsistent with histopathologic examination,possibility of deep infiltrating endometriosis should be considered and diagnosed by histopathologic examination.

关 键 词：子宫内膜异位症 宫颈肿瘤 诊断 鉴别 输尿管 肾盂积水 

分 类 号：R711.71[医药卫生—妇产科学]