盆腔外子宫内膜异位症的诊治进展  

Advances in the Diagnosis and Treatment of Extra-Pelvic Endometriosis

作　　者：冯静[1] 谢静燕(审校)[1] FENG Jing;XIE Jing-yan(Department of Gynecology,Nanjing First Hospital,Nanjing Medical University,Nanjing First Hospital,Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院/南京市第一医院妇科,210006

出　　处：《国际妇产科学杂志》2022年第6期704-708,共5页Journal of International Obstetrics and Gynecology

摘　　要：子宫内膜异位症(endometriosis,EMs)是育龄期妇女常见的良性疾病之一,发病率正逐年上升。EMs是指子宫内膜组织出现在正常子宫内膜以外的部位,大多累及盆腔脏器和壁腹膜,如卵巢、骶韧带等。EMs的发病机制尚未完全明确,目前普遍接受的理论有经血逆流假说、体腔上皮化生假说、医源性种植、淋巴转移和血行播散假说等。诊断可依靠临床表现、影像学检查和病理学结果。治疗方式主要有药物治疗和手术治疗。盆腔外子宫内膜异位症(extrapelvic endometriosis)是一种少见的EMs,发生在盆腔以外的部位,如腹壁、胸腔及会阴等。由于其发病较少,临床症状不典型,因此往往诊断较为困难,常会误诊。为提高盆腔外EMs的诊疗水平,要力求做到早期发现、及时诊断和规范化治疗,以改善患者预后。Endometriosis(EMs)is one of the common benign diseases in women of childbearing age,and its incidence is increasing year by year.EMs refers to the presence of endometrial tissue outside the normal endometrium,mostly involving pelvic organs and parietal peritoneum,such as the ovary and sacral ligament.The pathogenesis of EMs has not been completely clarified.Currently,the widely accepted theories include the hypothesis of menstrual reflux,coelomic epithelium metaplasia,iatrogenic implantation,lymphatic metastasis and hematogenous dissemination.Diagnosis depends on clinical findings,imaging and pathological outcomes.Management of this disease includes drug treatment and surgery.Extra-pelvic endometriosis is a rare EMs that occurs in areas outside the pelvic cavity,such as the abdominal wall,thorax and perineum.Due to its rare occurrence and atypical clinical symptoms,the diagnosis is often difficult and misdiagnosis often occurs.In order to improve the diagnosis and treatment of extra-pelvic endometriosis,it is necessary to achieve early detection,timely diagnosis and standardized treatment to optimize the prognosis of patients.

关 键 词：子宫内膜异位症 诊断 治疗 预后 腹部子宫内膜异位症 胸腔子宫内膜异位症 

分 类 号：R711.71[医药卫生—妇产科学]