子宫内膜异位症病变特点与痛经及疾病分期相关性分析

Correlation between pathological features and dysmenorrhea and disease stages in patients with endometriosis

目的：研究痛经及疾病分期与子宫内膜异位症患者病变特点的相关性。方法选取2013年4月至2014年4月在浙江台州市立医院进行治疗子宫内膜异位症的150例患者进行问卷调查，详细调查子宫内膜异位症患者痛经的发生情况，研究分析痛经与子宫内膜异位症患者病变的关系以及特点。结果子宫内膜异位症病灶各分型之间痛经程度有显著性差异（χ2＝3．856，P＜0．05），与卵巢型以及腹膜型相比较，混合型与深部浸润型的痛经程度更严重。子宫内膜异位症病灶不同临床病灶分期间粘连程度、浸润深度均有显著性差异（χ2值分别为4．713、3．892，均P＜0．05）。随着分期的增加，其粘连程度和浸润深度也增加。腹膜病灶和深部浸润是独立的影响因素（OR值分别为4．012、3．012，均P＜0．05）。结论痛经和疾病分期与子宫内膜异位症患者病灶的部位以及浸润程度有关。可以根据内异症患者疼痛的症状类型在某些方面预测子宫内膜异位症患者病灶分期以及浸润程度，为临床治疗提供参考。

Objective To study the correlation between dysmenorrhea and disease stage and pathological features of patients with endometriosis （EMS）. Methods From April 2013 to April 2014 150 cases of EMS treated in Zhejiang Taizhou Municipal Hospital accepted questionnaires survey to study dysmenorrhea and its relationship with pathological features. Results Dysmenorrhea degree was significantly different among patients with different types of EMS （x^2 = 3. 856, P 〈 0.05 ）. Compared with ovarian type and peritoneal type, patients with mixed and deep infiltration type of EMS suffered more severe dysmenorrhea. Adhesion degree and infiltration depth were significantly different among patients with different clinical stage （X2 value was 4.713 and 3. 892, respectively, both P 〈 0.05）. The degree of adhesion and infiltration depth increased with the increase of stage. Peritoneal lesions and deep infiltration were independent factors （ OR value was 4. 012 and 3. 012, respectively, both P 〈 0.05）. Conclusion Dysmenorrhea and disease stage of patients with EMS are correlated with the location of lesions and infiltration. Symptoms of dysmenorrhea can predict the disease stage and infiltration degree of patients with EMS in some aspects, and thus provide reference for clinical treatment.