摘要
目的：探讨医源性子宫内膜异位症发病机制、诊断及最佳治疗方法，预防盆腔外医源性子宫内膜异位症的发生和降低其复发率。方法：回顾性分析86例医源性子宫内膜异位症患者的临床资料。结果：86例医源性子宫内膜异位症患者中83例行手术治疗。其中腹壁切口瘢痕子宫内膜异位症56例，42例病灶位于皮下脂肪组织，病灶侵及腹直肌前鞘7例，病灶侵及腹直肌5例，侵及腹膜2例，腹壁手术瘢痕多发异位结节3例；术后随访2例复发，均为应用局部麻醉者。其他部位的内异症手术27例，其中会阴切口瘢痕内异症侵及肛门扩约肌3例，阴道壁内异症侵及阴道直肠膈3例，术后分别加用达那唑治疗3～6个月，经随访27例均无复发。2例腹壁子宫内膜异位症单纯应用药物治疗者，在治疗期间症状明显减轻，但肿块无明显缩小，均于停药后短期内再次出现症状。阴道后穹窿内异症1例，用达那唑治疗9个月，停药随访8年未复发。结论：医源性子宫内膜异位症最好的治疗方法是手术切除，采用硬膜外或骶管麻醉为宜；对手术不能彻底切除者加用治疗内异症的药物是最好方法；严格操作规程、提高手术技巧，可以避免医源性内异症的发生。
Objective： To explore the reasonably diagnosis and therapeutics of iatrogenic endometriosis , reduce the incidence and recurrence rate. Methods： 86 cases of iatrogenic endometriosis were analyzed retrospectively. Results ： The 83 cases in all 86 cases of endometriosis were treated with surgery. 56 cases were induced by abdomen scar, 42 cases were below epithelimn tissue, and 7 cases invaded former theca of ventro - rectus , 5 cases invaded ventro - rectus, 2 cases invaded peritoneum, 3 cases had many nodes induced by operative scars ; 2 cases with local anaesthesia were all recrudesce, 3 cases of endometriosis in perineal incision and 3 cases of endometriosis in vaginal wall were all cured with surgery and drugs. The other 2 cases were only treated with drugs end -of- dose failure. Conclusion： Surgery is the best method to iatrogenic endometriosis outside pelvic cavity. Epidural or caudal anaesthesia should be applied in the surgery. Simple drug treatment is always ineffective. The combination of surgery with drugs can prevent recurrence effectively to the cases which surgery can not completely remove lesions. Strict roles to improve surgical techniques is the the best way to prevention of iatrogenic endometriosis.
出处
《中国妇幼保健》
CAS
北大核心
2008年第22期3095-3097,共3页
Maternal and Child Health Care of China
关键词
子宫内膜异位症
医源性
盆腔外
麻醉
Endometriosis
Iatrogenic
Outside pelvic cavity
Anaesthesia
