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子宫内膜异位症的病理生理学、诊断与治疗

Pathophysiology, diagnosis and treatment of endometriosis.

作者信息

Schindler A E

机构信息

Institute for Medical Research and Education, Essen, Germany.

出版信息

Minerva Ginecol. 2004 Oct;56(5):419-35.

Abstract

Endometriosis is generally a benign condition. However, there is a tendency towards progression and in part deep infiltrating processes occur, which can lead to obstruction and even silent loss of organ function such as kidney failure. Hereditary, genetic and immunological peculiarities have been found. Important are symptoms such as pain and infertility, which burden the life of the women involved. In spite of extensive research in the past the pathogenesis and epidemiology of the disease are not definitely clarified as yet. The estimated prevalence of endometriosis ranges between 10% and even more than 50% depending on the underlying problems of the women studied. Besides the main location of the disease within the pelvis also extra pelvic locations have been found (lung, lymph nodes, scars). The diagnosis should be established by histological verification. The main therapeutic modalities consist of surgery and medical treatment or combinations, which need to be individually adjusted, because of the high risk of recurrence and progression of the disease. The aim should be early detection and treatment as complete as possible, since symptom relief, resolution or prevention of infertility and decrease of recurrences are at their best under these circumstances.

摘要

子宫内膜异位症通常是一种良性疾病。然而,它有进展的趋势,部分会出现深部浸润性病变,这可能导致梗阻,甚至器官功能的隐匿性丧失,如肾衰竭。已经发现了遗传、基因和免疫方面的特殊性。疼痛和不孕等症状很重要,它们给患病女性的生活带来负担。尽管过去进行了广泛研究,但该疾病的发病机制和流行病学尚未完全明确。根据所研究女性的潜在问题不同,子宫内膜异位症的估计患病率在10%至超过50%之间。除了疾病在盆腔内的主要发病部位外,还发现了盆腔外的发病部位(肺、淋巴结、瘢痕)。诊断应通过组织学证实来确立。主要治疗方式包括手术、药物治疗或联合治疗,由于疾病复发和进展的风险高,这些治疗需要个体化调整。目标应该是尽早发现并尽可能彻底地治疗,因为在这种情况下,症状缓解、解决或预防不孕以及减少复发的效果最佳。

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