子宫内膜异位症患者盆腔疼痛和病灶特点的相关性研究

Analysis of the relation between the pelvic pain and the lesion features in patients with endometriosis

目的 研究子宫内膜异位症患者盆腔疼痛和病灶特点之间的的相关性。方法 选择于2011年5月~2013年9月在我院经病理检查及腹腔镜检查确诊为子宫内膜异位症的患者130例,回顾性分析该部分患者盆腔疼痛与病灶特点之间的关系。结果 在130例子宫内膜异位症患者中,21例单纯子宫内膜异位囊肿患者无盆腔疼痛,109例子宫内膜异位囊肿合并腹膜病灶、深部浸润型结节、盆腔粘连患者存在不同程度的盆腔疼痛;在盆腔疼痛的发生频率方面,病变部位由高到低排列依次为子宫骶韧带、子宫直肠凹、输卵管/子宫表面、输卵管/反折腹膜和阔韧带,且77例中重度盆腔粘连患者,79例深部浸润型患者的盆腔疼痛发生率、疼痛程度明显高于22例轻度盆腔粘连患者和30例浅表型患者,组间差异具统计学意义（P〈0.05）。结论 子宫内膜异位症患者盆腔疼痛和病灶特点之间有明显关联,其中子宫直肠凹、盆腔粘连、骶韧带深部病灶是盆腔疼痛的主要病变类型。

Objective To investigate the relation between pelvic pain and lesion features in patients with endometriosis. Methods 130 patients with endometriosis diagnosed by iaparoscopy and pathology from May 2011 to September 2013 were analyzed retrospectively and the relationship between pelvic pain and lesion features was evaluated. Results In 130 patients with endometriosis, the pelvic pain was not found in 21 patients with simple endometrial cyst and 109 patients with simple endometrial cyst complicated peritoneal lesion, pelvic adhesion and deeply infiltrating nodules suffered from chronic pelvic pain on the contrary. The lesion from high to low order of round ligament of uterus, uterine rectum cavity, oviduct/uterus, fallopian tube surface/peritoneal fold and broad ligament, moreover, the incidence rates of pelvic pain in 77 cases with moderate or serious pelvic adhesion and in 83 cases with deeply infihrating lesions were remarkably higher than those in 22 cases with mild pelvic adhesion and 30 cases with superficial infiltrating lesions, respectively （P 〈 0.05）. Conclusion The pelvic pain of endometriosis is notably related to endometriotic lesion features, and pelvic adhesion and deeply infiltrating lesions in uterosaeral ligaments and rectouterine pouch are the most frequent reasons resulting in pelvic pain.