输尿管子宫内膜异位症的诊断与治疗(附九例报告)

Diagnosis and Treatment of Ureteral Endometriosis(Reports 9 Cases)

目的:探讨输尿管子宫内膜异位症的诊断与治疗方法。方法:回顾性分析9例输尿管子宫内膜异位症患者的临床诊治资料。所有患者术前均行B超和静脉尿路造影(IVU)检查,1例行逆行尿路造影(RUG)。9例均行手术治疗,切除盆腔包块,1例行输尿管粘连松解术;8例行输尿管病变切除,其中7例行端端吻合术,1例因侵犯壁间段,行输尿管膀胱吻合术。皆留置D-J管。术后皮下注射抑那通,共3个月。结果:9例术后4周拔除D-J管。术后3个月复查症状消失,B超输尿管梗阻均解除,肾积水缓解。随访2年,未见复发。结论:应重视对输尿管子宫内膜异位症的早期诊断。输尿管子宫内膜异位症缺乏典型临床表现,诊断子宫内膜异位症的患者,应定期行泌尿B超检查。IVU、RUG或MRU,可进一步明确病变。治疗原则是解除输尿管梗阻,同时治疗盆腔子宫内膜异位症。

Objective.-To study the diagnosis and treatment of ureteric endometriosis. Methods： The clinical data of 9 cases of ureteric endometriosis were reviewed and report age was 42.5 years old. All the cases were undertaken ultrasound and intraveno as preoperative diagnosis, one was treated with retrograde urography（RUG） ; treated with operation of resecting pel hesions of ureter,8 were treated with end-to-end ureteroureterostomy, 1 of croachment of inter-paries section. A treatment was hypodermic injection o vic cavity resection masses,lnc ing one was treate ed, whose average us urogram（iVU） all the cases were d with lysis of adof ureteropathy affection,7 of 8 were 8 was treated 11 the patients f Enantone for with ureterovesical anastomosis were detained Doub three month e-J s. Results treated with due to enstent. Postoperative At several weeks after operation 9 cases were treated with exelcymosis of Double-J stent. All symptoms were van- ished in 3 months after operation and obstruction of ureter was relieved, nephrohydrosis was improved. All patients have been followed up for 2 years and there was no recurrence. Conclusion： Early diagnosis of ureterlc endometriosis should be reconstructed. Ureteral endometriosis was lack of typically clinical manifestation. Severe nephrohydrosis will not be observed until manifestation. Patient who is diagnosed of endometriosis should be inspected by ultrasound regularly. IVU,RUG or MRU can be used to identify process. Therapeutic principle is to relief obstruction of ureter and treat pelvic endometriosis, if diagnosis and treatment can be done punctually, nephrohydrosis of most patients can be released.