宫颈子宫内膜异位症106例临床诊疗分析  

Efficacy of 3 treatments for cervical endometriosis:clinical analysis of 106 cases

作　　者：杨君[1] 龙馨[1] 颜丽[1] 周德平[1] YANG Jun;LONG Xin;YAN Li;ZHOU Deping(Department of Cervical Diseases,Chongqing Health Center for Women and Children,Chongqing,401147,China)

机构地区：[1]重庆市妇幼保健院宫颈疾病诊治中心,重庆401147

出　　处：《第三军医大学学报》2020年第24期2413-2418,共6页Journal of Third Military Medical University

基　　金：重庆市科卫联合重点基金(2019ZDXM051)。

摘　　要：目的评估3种方式治疗宫颈子宫内膜异位症的临床疗效。方法回顾性分析重庆市妇幼保健院宫颈疾病诊治中心2013年1月至2019年3月106例确诊为宫颈子宫内膜异位症患者的临床资料,按照患者选择的不同治疗方法分为3组:激光组(44例)、药物组(聚甲酚磺醛栓阴道上药,37例)、联合组(激光治疗联合口服达英-35片,25例),统计分析评价其临床疗效。结果(1)3组总有效率分别为93.18%(41/44)、78.38%(29/37)、96.00%(24/25),组间比较差异有统计学意义(χ2=6.076,P<0.05)。(2)各治疗组内比较:在激光组和联合组内,原有病灶面积大小对临床疗效的影响,差异无统计学意义(χ2激光=-1.538,P>0.05;χ2联合=-1.239,P>0.05);药物组中病灶累及≤2个象限者,治愈率高于病灶累及>2个象限者(χ2=-2.796,P<0.01)。(3)各治疗组内比较,激光组内无其他部位子宫内膜异位症患者治愈率高于有合并其他部位子宫内膜异位症患者(Z激光=-2.124,P<0.05);药物组和联合组中临床疗效不受是否合并其他部位子宫内膜异位症影响,差异皆无统计学意义(Z药物=-1.337,P>0.05;Z联合=-0.873,P>0.05)。(4)术后6~12个月评估,联合组无复发;原有病灶面积及是否合并其他部位子宫内膜异位症对激光组复发率无影响(P>0.05);药物组内,病灶累及象限>2个、合并有其他部位子宫内膜异位症患者复发率更高(P<0.05)。结论治疗宫颈子宫内膜异位症应根据宫颈局部病灶面积及是否合并其他部位子宫内膜异位症,选择不同治疗方案。Objective To evaluate the clinical efficacy of 3 treatments for cervical endometriosis.Methods Clinical data of 106 patients with cervical endometriosis treated in our center from January 2013 to March 2019 were collected and retrospectively analyzed.According to the treatments,they were assigned into yttrium aluminum garnet(YAG)laser group(n=44,laser group),transvaginal administration of policresulen suppositories group(n=37,medication group)and YAG laser along with oral contraceptive group(n=25,Diane-35,combination group).The clinical efficacy and adverse effects were evaluated and compared among the 3 groups during the 6~12 months’follow-up.Results(1)The total effective rates were 93.18%(41/44),78.38%(29/37)and 96.00%(24/25),respectively,in the laser,medication and combination groups,with statistical difference among them(Chi-square=6.076,P<0.05).(2)The original lesion size showed no effect on clinical efficacy both in the laser group(Chi-square=-1.538,P>0.05)and the combination group(Chi-square=-1.239,P>0.05).In the medication group,the patients with lesions involving≤2 quadrants had a higher recovery rate than those with>2 quadrants(Chi-square=-2.796,P<0.01).(3)In the laser group,the recovery rate of the patients with simple cervical endometriosis was higher than that of those with other parts of endometriosis(Z=-2.124,P<0.05).But,the rate was not affected by whether involving other parts or not in the medication(Z=-1.337,P>0.05)and combination groups(Z=-0.873,P>0.05).(4)During the follow-up of 6~12 months,no recurrence was found in the combination group.The size of original lesion and involvement of other parts had no effect on the recurrence rate in the laser group(P>0.05).In the medication group,the patients with lesions of>2 quadrants or with other parts of endometriosis had higher recurrence rate(P<0.05).Conclusion Size of cervical lesions and whether involved with other parts of endometriosis should be considered when choosing different treatment methods for cervical endometriosis.

关 键 词：子宫颈 子宫内膜异位症 治疗 

分 类 号：R181.32[医药卫生—流行病学] R711.71[医药卫生—公共卫生与预防医学]