青春期子宫内膜异位症89例  

Adolescent ovarian endometriosis:A 89-case study

作　　者：孙璐[1] 范晓东[1] 李雯[2] 杨潇潇 朱颖军[1] SUN Lu;FAN Xiaodong;LI Wen;YANG Xiaoxiao;ZHU Yingjun(Department of Gynecology,Tianjin Central Hospital of Gynecology Obstetrics,Tianjin 300100,China)

机构地区：[1]天津市中心妇产科医院妇科,天津300100 [2]天津市中心妇产科医院,天津市人类发育与调控重点实验室,天津300100 [3]合肥工业大学,合肥工业大学重大疾病代谢及营养调控安徽普通高校重点实验室,合肥230601

出　　处：《实用医学杂志》2022年第14期1778-1781,共4页The Journal of Practical Medicine

基　　金：国家青年科学基金项目(编号:81801456);天津市自然科学基金项目(编号:20JCQNJC01750);天津市卫生健康委员会科技项目(编号:ZC0093);天津市人类发育与生殖调控重点实验室开放基金(编号:2021XHY01)。

摘　　要：目的分析青春期子宫内膜异位症(EMs)患者的临床病理特征及治疗情况,探讨青春期EMs患者适宜的治疗方式及时机。方法回顾性分析2011-2018年收住院的89例青春期(年龄≤21岁)EMs患者临床资料,其中86例为卵巢型EMs(OE),3例为腹膜型EMs,随机抽取同期住院的非青春期OE患者89例进行对比分析。结果(1)青春期EMs患者痛经发病率较非青春期组更高,出现痛经距初潮时间更短,初潮年龄更早(P<0.005)。(2)青春期组患者卵巢肿物总直径大于非青春期组(P<0.005),其中9例发生OE破裂急诊手术。(3)青春期及非青春期组腹腔镜保守手术完成率分别为91.01%及86.52%,临床分期均为重度(Ⅲ/Ⅳ期)患者更多。(4)青春期组患者术后痛经缓解率为68.29%,术后3年复发率为18.87%(10/53),术后复发可能与子宫直肠陷窝封闭有关(P<0.005)。结论青春期EMs患者发病早,临床分期高以OE为主要表现,肿物直径较大,易发生破裂,应尽早手术治疗。腹腔镜保守手术是治疗青春期EMs的有效方式,其术后复发可能与子宫直肠陷窝封闭有关。Objective To analyze the clinical manifestation and treatment effect of endometriosis(EMs)in adolescent,to explore appropriate treatment and timingfor adolescent EMs patients.Methods We retrospectively analyzed the clinical data of 89 adolescent(age≤21 years)EMs patients hospitalized from 2011 to 2018.Eightysix patients were diagnosed as ovarian endometrioma(OE)and 3 patients as peritoneal EMs.Withrandom sampling,another 89 adult OE patients hospitalized in the same periodwere enrolled for comparative analysis.Results(1)Compared to those in adult group,higher dysmenorrhea rate;shorter interval time from dysmenorrhea happened to menarche and earlier menarche age were found in adolescent group.(2)Adolescent group had larger cyst diameter than adult group(P<0.005)and 9 patients had underwent emergency surgery because of ovarian cyst rupture.(3)Laparoscopic conservative surgery was completed successful in 91.01%of the patients in adolescent group and in 86.52%in adult group.Most of the patients were diagnosed as stageⅢ/Ⅳin the two groups.(4)Dysmenorrhea release rate and 3 years post operation recurrence rate was 68.29%(28/41)and 18.87%(10/53)respectively in adolescent group.Close of Douglas′cul-de-sacmay have relationship with post operation recurrence.Conclusion Adolescent EMs is featured by early onset,and OE is the mainly classification.OE of adolescent patients has the featuresof larger ovarian cyst diameter than OE of adult patients and has the possibility to rupture,which requires surgery as soon as possible.Laparoscopic conservative surgery is an effective treatment for OEin adolescent patients,and close of Douglas′cul-de-sacmay have relationship with post operation recurrence.

关 键 词：卵巢型子宫内膜异位症 青春期 痛经 保守手术 复发 

分 类 号：R711.71[医药卫生—妇产科学]