81例盆腔后部深部浸润型子宫内膜异位症诊治分析

Diagnosis and treatment of posterior deep infiltrating endometriosis:A report of 81 cases

目的探讨盆腔后部深部浸润型子宫内膜异位症诊断及治疗方法。方法对我院1999年1月-2009年12月因子宫内膜异位症住院手术并经组织病理学确诊为盆腔后部深部浸润型子宫内膜异位症(PDIE)81例患者资料进行分析。我院11年共收治子宫内膜异位症3246例,其中PDIE81例(3.28%)。手术包括直肠部分切除加端端吻合术17例(20.98%),病灶切除64例(79.02%)。结果手术后疼痛显著缓解50例(69.44%),轻微缓解12例(16.67%),无效10例(13.89%)。9例失访,失访率11.11%。8例手术同时行直肠壁损伤修补(12.5%)。6例术前误诊为肠道肿瘤,误诊率7.4%。结论盆腔后部深部浸润型子宫内膜异位症诊断名称有待规范。本病治疗以缓解症状为主,手术方法根据患者病情及术者水平选择,尽量减少手术并发症。

Objective To study the diagnosis and treatment of posterior deep infiltrating endometriosis（PDIE）.Methods Data about 3 246 endometriosis patients admitted to our hospital from January 1999 to December 2009 were analyzed.Of the 81 PDIE patients（3.28%） who were treated with operation,17（20.98%） underwent partially rectodectomy with end-to-end anatomosis,and 64（79.02%） underwent endometriotic focus excision.Results After operation,the pain was significantly relieved in 50（69.44%） patients,mildly relieved in 12（16.67%） patients,and did no relieve in 10（13.89%） patients.Nine patients（11.11%） were lost of follow-up,8（12.5%） patients underwent rectodectomy with repair of rectal wall,and 6 patients（7.4%） were misdiagnosed as rectum tumor.Conclusion The diagnosis of PDIE should be standardized.PDIE should be treated by alleviating its symptoms.Selection of surgical procedure depends on the patient＇s condition and the operator＇s skills.Complications should be minimized.