Wang Yan-yan, Leng Jin-hua, Shi Jing-hua, Li Xiao-yan, Lang Jing-he
Department of Obsterics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhonghua Fu Chan Ke Za Zhi. 2010 Apr;45(4):260-3.
To investigate the relationship between the distribution of nerve fibers in multiple endometriosis lesions and pelvic pain.
From Sept. 2007 to Sept. 2008, 120 endometriosis patients treated in Peking Union Hospital were enrolled in this study, which including 19 cases with stage I, 29 cases with stage II, 44 cases with stage III and 28 cases with stage IV. The pain symptom was evaluated by visual analogue scales (VAS) score and nerve fibers in multiple endometriosis lesions were detected by immunohistochemical staining.
The number of nerve fibers in multiple endometriosis lesions were (29.74+/-17.33)/mm2 in uterosacral ligament, (24.53+/-13.34)/mm2 in vaginal septum, (17.09+/-10.09)/mm2 in uterus rectum crux, (6.77+/-4.21)/mm2 in peritoneal endometriosis lesions, (0.07+/-0.25)/mm2 in endometriosis ovarian cyst wall. The number of nerve fibers in uterosacral ligament was mostly correlated with the degree of pain (r=0.56). The nerve fibers of uterus rectum crux and vaginal septum were correlated with defecation pain (r=0.58 and 0.41) and dyspareunia (r=0.82 and 0.67), which were significantly higher than those in endometriosis leision in peritoneum and ovary. There was no significant different number of nerve fibers among different stage disease (P>0.05).
There was significantly different distribution of nerve fibers in multiple endometriosis lesions, which was correlated with dysmenorrhea, anus pain, dyspareunia and chronic pelvic pain, not with clinical staging.
探讨多发性子宫内膜异位症病灶中神经纤维分布与盆腔疼痛之间的关系。
选取2007年9月至2008年9月在北京协和医院接受治疗的120例子宫内膜异位症患者，其中I期19例，II期29例，III期44例，IV期28例。采用视觉模拟评分法（VAS）评估疼痛症状，通过免疫组化染色检测多发性子宫内膜异位症病灶中的神经纤维。
子宫骶韧带多发性子宫内膜异位症病灶中神经纤维数量为（29.74±17.33）/mm²，阴道隔为（24.53±13.34）/mm²，子宫直肠陷凹为（17.09±10.09）/mm²，腹膜子宫内膜异位症病灶为（6.77±4.21）/mm²，子宫内膜异位症卵巢囊肿壁为（0.07±0.25）/mm²。子宫骶韧带中神经纤维数量与疼痛程度相关性最强（r=0.56）。子宫直肠陷凹和阴道隔的神经纤维与排便疼痛（r=0.58和0.41）及性交困难（r=0.82和0.67）相关，显著高于腹膜和卵巢子宫内膜异位症病灶中的神经纤维。不同分期疾病的神经纤维数量无显著差异（P>0.05）。
多发性子宫内膜异位症病灶中神经纤维分布存在显著差异，与痛经、肛门疼痛、性交困难及慢性盆腔疼痛相关，与临床分期无关。
