青春期子宫内膜异位症30例临床分析

Clinical analysis of 30 cases with adolescent endometriosis

目的:探讨子宫内膜异位症青春期发病的临床特点、诊断及治疗。方法:总结分析30例青春期子宫内膜异位症患者的资料。结果:诊断内膜异位症距离初潮年龄平均间隔时间为4.5年,发病距就诊平均时间为2.3年,临床表现为盆腔包块、痛经、慢性盆腔痛、急性腹痛。30例患者均经手术治疗,其中16例(53.3%)进行了腹腔镜诊断及治疗,术前误诊18例(60.0%),根据美国生育协会修订的子宫内膜异位症分期(R-AFS)标准,Ⅰ期4例(13.3%),Ⅱ期5例(16.7%),Ⅲ期13例(43.3%),Ⅳ期8例(26.7%),其中伴发生殖道畸形3例,占10.0%。结论:青春期子宫内膜异位症的临床主要症状为盆腔包块和痛经,手术是其主要治疗手段,术后用药可降低复发率。

Objective：To discuss the clinical characteristics,diagnosis and treatment of adolescent endometriosis.Methods：A retrospective analyzed of 30 cases of adolescent patients with endometriosis clinical data.Results：The average interval of adolescent endometriosis diagnosis from menarche age were 4.5 years.The average time of disease occurrence from diagnosis were 2.3 years.Clinical manifestation was pelvic mass,dysmenorrhea,chronic pelvic pain,acute abdominal pain.All of 30 cases were treated by operation.16 patients（53.3%） were diagnosed and treated by laparoscopy.Preoperative misdiagnosis were 18 cases（60.0%）.According to the endometriosis staging standard（R-AFS） revised by American Fertility association.Ⅰ phase were 4 cases（13.3%）.Ⅱ phase were 5 cases（16.7%）.Ⅲ phase were 13 cases（43.3%）.Ⅳ phase were 8 cases（26.7%）.The concomitant genital deformity were 3 cases（10.0%）.Conclusion：The main clinical symptoms of adolescent endometriosis is pelvic mass and dysmenorrheal.Operation is the main treatment method.Postoperative medication can decrease the recurrent rate.