肠道子宫内膜异位症诊断和治疗的新观点  

Bowel Endometriosis:Current Perspectives on Diagnosis and Treatment

作　　者：梁炎春 韦雅婧 杨如玉 姚书忠(译/审校)[6] Nassir Habib Gabriele Centini Lucia Lazzeri Nicola Amoruso Lionel El Khoury Errico Zupi Karolina Afors Nassir Habib;Gabriele Centini;Lucia Lazzeri;Nicola Amoruso;Lionel El Khoury;Errico Zupi;Karolina Afors(Department of Obstetrics and Gynaecology,Beaujon Hospital-University of Paris,Clichy Cedex 92110,France;Department of Molecular and Developmental Medicine,University of Siena,Ospedale Santa Maria alle Scotte,Siena 53100,Italy;Department of Colorectal Surgery-Delafontaine Hospital,Saint Denis 93200,France;Department of Obstetrics and Gynaecology,Whittington Hospital,London,UK)

机构地区：[1]不详 [2]Department of Obstetrics and Gynaecology,Beaujon Hospital-University of Paris,Clichy Cedex 92110,France [3]Department of Molecular and Developmental Medicine,University of Siena,Ospedale Santa Maria alle Scotte,Siena 53100,Italy [4]Department of Colorectal Surgery-Delafontaine Hospital,Saint Denis 93200,France [5]Department of Obstetrics and Gynaecology,Whittington Hospital,London [6]中山大学附属第一医院妇科,广东510080

出　　处：《国际妇产科学杂志》2020年第6期676-683,F0003,共9页Journal of International Obstetrics and Gynecology

基　　金：国家自然科学基金-青年科学基金项目(81701416);2019年广东大学生科技创新培育专项资金项目(重点项目)(pdjh2019a0004);2019年中山大学大学生创新训练计划项目(201901097);2019年中山大学青年教师培育项目(19ykpy73);2020年广东省科技创新战略专项资金(“攀登计划”专项资金)(pdjh2020b0015)。

摘　　要：子宫内膜异位症是一种主要影响育龄妇女的慢性疾病。部分肠道子宫内膜异位症患者可能是无症状的,除了不孕之外,有部分患者表现为各种各样的症状,如排便习惯改变(便秘或腹泻)、排便困难、痛经和性交痛等。迄今为止,对于疑似有肠道受累的子宫内膜异位症患者,尚无明确的评估指南。目前的检查手段包括经阴道或经直肠超声检查、核磁共振成像和气钡双重对比造影。不同的检查方法可提供更多的信息,包括是否存在病灶、病灶的位置和累及的范围等,确保患者充分了解病情,同时也可对术前计划进行优化。如需手术治疗,应由经验丰富的医生在有多学科护理条件的中心进行手术。治疗应根据患者的症状和意愿进行调整,目的是尽可能切除所有病灶的同时保留器官的功能。本综述将讨论肠道子宫内膜异位症诊断和处理的最新观点。Endometriosis is a chronic condition primarily affecting young women of reproductive age.Although some women with bowel endometriosis may be asymptomatic patients typically report a myriad of symptoms such as alteration in bowel habits(constipation/diarrhoea)dyschezia,dysmenorrhoea and dyspareunia in addition to infertility.To date,there are no clear guidelines on the evaluation of patients with suspected bowel endometriosis.Several techniques have been proposed including transvaginal and/or transrectal ultrasonography,magnetic resonance imaging,and double-contrast barium enema.These different imaging modalities provide greater information regarding presence,location and extent of endometriosis ensuring patients are adequately informed whilst also optimizing preoperative planning.In cases where surgical management is indicated,surgery should be performed by experienced surgeons,in centres with access to multidisciplinary care.Treatment should be tailored according to patient symptoms and wishes with a view to excising as much disease as possible,whilst at the same time preserving organ function.In this review article current perspectives on diagnosis and management of bowel endometriosis are discussed.

关 键 词：子宫内膜异位症 肠道子宫内膜异位症 节段性切除术 复发 不孕 

分 类 号：R71[医药卫生—妇产科学]