Mahmood T A, Templeton A
Department of Obstetrics and Gynaecology, Aberdeen Maternity Hospital, UK.
Hum Reprod. 1990 Nov;5(8):965-70. doi: 10.1093/oxfordjournals.humrep.a137229.
A group of 50 infertile female patients was assessed laparoscopically to study the natural history of endometriosis. They were treated either with danazol (n = 21), or diathermy ablation (n = 13) or had conservative surgery with postoperative danazol (n = 5) or were left untreated (n = 11). All these patients had second look laparoscopy performed after a mean interval of 12 months (range 9-18 months). Improvement was noted among 53% of those treated with danazol, 70% treated with diathermy, 80% treated with surgery and danazol and 27% of those left untreated. The status of endometriosis remained unchanged among 14% of those treated with danazol, 8% treated by diathermy and 9% of those left untreated. However, the disease became worse in the remaining women, 33% in the danazol treated group, 22% treated by diathermy, 20% treated with surgery and danazol and 64% of those left untreated. Thus treatment hinders progression in a majority of patients, and conversely, there is a small but definite spontaneous regression rate.
一组50名不孕女性患者接受了腹腔镜检查，以研究子宫内膜异位症的自然病程。她们分别接受了以下治疗：达那唑治疗（n = 21）、透热消融治疗（n = 13）、术后使用达那唑的保守手术治疗（n = 5）或未接受治疗（n = 11）。所有这些患者在平均间隔12个月（9 - 18个月）后接受了二次腹腔镜检查。接受达那唑治疗的患者中有53%病情改善，接受透热消融治疗的患者中有70%病情改善，接受手术加术后达那唑治疗的患者中有80%病情改善，未接受治疗的患者中有27%病情改善。接受达那唑治疗的患者中有14%、接受透热消融治疗的患者中有8%以及未接受治疗的患者中有9%的子宫内膜异位症病情保持不变。然而，其余患者的病情恶化，接受达那唑治疗的患者中有33%、接受透热消融治疗的患者中有22%、接受手术加术后达那唑治疗的患者中有20%以及未接受治疗的患者中有64%病情恶化。因此，治疗可阻止大多数患者病情进展，相反，存在一小部分但确切的自发缓解率。
