子宫腺肌症合并输尿管子宫内膜异位症的诊断与治疗  

Diagnosis and treatment of uterine gland muscle sickness merge ureter endometriosis sickness

作　　者：李睿[1] 李雅丽[1] 魏利[1] 武海英[1] 徐亚辉[1] 

机构地区：[1]河南省人民医院妇产科,郑州450003

出　　处：《医药论坛杂志》2011年第15期57-58,共2页Journal of Medical Forum

摘　　要：目的总结子宫腺肌症合并输尿管子宫内膜异位症的临床特点及诊断与治疗的方法。方法回顾性分析6例子宫腺肌症合并输尿管子宫内膜异位症患者的临床资料、术后随访资料,并对这些结果进行对比分析。结果术前B超检查均发现输尿管中上段扩张、肾积水;IVP检查6例,均提示输尿管下段狭窄、输尿管上段扩张,肾积水4例。患者均为单侧发病,均为输尿管下1/3段呈现子宫内膜异位症表现,2例行输尿管松解术并内置双J管;4例行输尿管膀胱再植术。术后病理检查均证实为输尿管子宫内膜异位症。6例均同时行全子宫切除术。6例均术后结合药物内分泌治疗,皮下注射诺雷德3.75mg3个疗程。随访6例,随访时间3年,症状均消失,定期复查B超及IVP,肾积水均缓解。未发现子宫内膜异位症复发。结论子宫腺肌症病人有可能合并输尿管子宫内膜异位症,术前术中应仔细检查,一旦发现,应尽早解除梗阻,保护肾功能。术后结合内分泌治疗可降低复发率。Objective To summarize the clinical characteristic, diagnosis and treatment method of uterine gland muscle sickness merge ureter endometriosis sickness. Methods After retrospectively analyze 6 example uterine gland muscle sickness merge ureter endometriosis sickness patient＇s clinical material, technique, makes a followup visit the material, and carries on the contrastive analysis to these results. Results Preoperation the ultrasound inspection discovered that in the ureter the upside expands, the kidney water; IVP inspects 6 cases, prompts the ureter lower segment to be narrow, the ureter upside expands, kidney water 4 cases. The patient is the one - sided morbidity, is the ureter next 1/3 section presents the endometriosis sickness performance, 2 cases ureter lyses and built - in double J tube; 4 cases ureter urinary bladder reimplantation. After the technique, the pathology inspection confirms for the ureter endometriosis sickness. 6 cases with fashionable entire womb excision method, after 6 cases even techniques, unifies the medicine internal secretion treatment, hypodermic injection Redd 3.75rag 3 treatment course. Follow -up 6 cases, the revisit time 3 years, the symptom vanishes, the regular reexamination ultrasound and IVP, the kidney water alleviates. Has not discovered the endometriosis sickness recrudescence. Conclusions Uterine gland muscle sickness patient has the possibility to merge the ureter endometriosis sickness, before the technique, in the technique should inspect carefully, once discovered that should relieve the obstruction as soon as possible, protects the kidney function. Postoperation unifies the endocrine treatment to be possible to cut the recurfence rate.

关 键 词：子宫腺肌症 输尿管梗阻 诊断 治疗 

分 类 号：R711.32[医药卫生—妇产科学]