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[子宫内膜异位症的临床方面]

[Clinical aspects of endometriosis].

作者信息

Stummvoll W, Kapshammer E

机构信息

Gynäkologischen Abteilung des Krankenhauses der Barmherzigen Schwestern, Linz.

出版信息

Wien Med Wochenschr. 1999;149(13):358-60.

Abstract

Endometriosis is defined as the presence of endometrial tissue outside the uterine cavity. Its pathogenesis ist still not definitely clear. The incidence today is stated very differently, most studies report an incidence of 10-15% for women in their reproductive age. The leading symptoms are as dysmenorrhoea and chronic pelvic pain, which do not have to occur synchronously with the menstrual cycle. Endometriosis is a chronic, progressive disease and may lead to severe destructions of reproductive organs and infertility in advanced stages. Clinical symptoms are often uncharacteristic, and imaging techniques may not be able to give the correct diagnosis; furthermore, there is often no direct relationship between the extent of the disease and the severity of the symptoms. Differential diagnosis other inflammatory diseases as far as malignant tumors. Therefore early indication of surgical affirmation and therapy of endometriosis by laparoscopic techniques is recommended as soon as symptoms occur, even in adolescent girls. Endometriosis genitalis externa is presenting as peritoneal or ovarian implants of different shape, as endometriotic cyst of the ovaries or as deep nodal implants in the spatium rectovaginale, which possibly represent different entities.

摘要

子宫内膜异位症的定义是子宫腔外存在子宫内膜组织。其发病机制仍不明确。如今其发病率的说法差异很大,大多数研究报告称育龄女性的发病率为10% - 15%。主要症状为痛经和慢性盆腔疼痛,这些症状不一定与月经周期同步出现。子宫内膜异位症是一种慢性、进行性疾病,在晚期可能导致生殖器官严重受损和不孕。临床症状往往不典型,影像学技术可能无法做出正确诊断;此外,疾病的程度与症状的严重程度之间通常没有直接关系。需要与其他炎症性疾病乃至恶性肿瘤进行鉴别诊断。因此,即使在青春期女孩中,一旦出现症状,建议尽早通过腹腔镜技术对子宫内膜异位症进行手术确诊和治疗。外阴子宫内膜异位症表现为不同形状的腹膜或卵巢植入物、卵巢子宫内膜异位囊肿或直肠阴道间隙的深部结节植入物,这些可能代表不同的实体。

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