子宫畸形致青春期子宫内膜异位症临床分析

Clinical analysis of endometriosis induced by uterine malformations in puberty

目的：探讨子宫畸形致青春期子宫内膜异位症的发病原因、诊断方法及治疗原则。方法：2002年6月-2004年12月间我院经官腔镜结合超声对6例青春期少女进行检查、诊断，经手术及病理证实为子宫畸形合并子宫内膜异位症，对其临床和病理资料进行回顾性分析。结果：①临床表现：6例患者均以原发性痛经为主要表现，其中1例先天无阴道患者表现为周期性腹痛。②官腔镜结合超声检查：6例病例中诊断盲角子宫3例，残角子宫3例，其中5例合并与病侧子宫同侧的卵巢子宫内膜异位囊肿。③手术方式：以切除残角或盲角子宫为基本术式，盲角子宫者行大部盲角子宫切除术，术中完全切除盲角子宫内子宫内膜，合并卵巢巧克力囊肿者均行囊肿核除术、保留正常卵巢组织及另侧子宫，最终旨在保留正常生育功能。结论：官腔镜结合B超检查可在术前早期明确诊断青春期少女子宫畸形合并子宫内膜异位症，早期诊断和早期治疗对保证青春期少女的生育功能意义重大。

Objective： To investigate the cause, diagnostic methods, treatment of endometriosis induced by uterine malformations in puberty. Methods ： From June 2002 to December 2004, 6 cases of puberty girls with uterine malformations complicated by endometriosis diagnosed, operated and checked by pathology to analyze the clinical and pathologic data. Results： All the patients complained of primary dysmenorrhea, one of them who congenitally had no vagina complained of periodic pain of abdomen. 3 cases rudimentary uterine horn and 3 cases blind uterine horn were diagnosed by hysteroscopy combined with uhrasonography, 5 cases of those complicated by chocolate cyst of ovary. The basic operational way was rudimentary uterine horn or blind uterine horn resection. The endometrium in the blind uterine horn was resected completely. In the cases complicated by chocolate cyst of ovary, the cyst of ovary was resected and reserved the normal ovary tissue and the opposite uterine to reserve the potentia generational function of the patients. Conclusion： Hysteroscopy combined with uhrasonography is able to diagnose uterine malformations in puberty before operation correctly. . Earlier diagnosis and earlier treatment of uterine malformations complicated by endometriosis is important to potentia generational function in puberty.