Department of Obstetrics and Gynecology, McGill University, Montréal, QC; Department of Obstetrics and Gynecology, King Abdulaziz University, Jeddah, Saudi Arabia.
Department of Obstetrics and Gynecology, McGill University, Montréal, QC.
J Obstet Gynaecol Can. 2021 Apr;43(4):440-446. doi: 10.1016/j.jogc.2020.12.008. Epub 2021 Feb 13.
To evaluate the association between endometriosis and bowel obstruction or intussusception using a large population database.
This was a population-based study using data from the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS) from 2005 to 2014. We studied women aged 18 to 55 years without inflammatory bowel disease or cancer. Multivariate logistic regression was used to examine the association between endometriosis and bowel obstruction.
Of the 18 427 520 women who met the criteria for inclusion, 96 539 had experienced bowel obstruction, for an overall prevalence of 52 per 10 000, and 3825 had experienced intussusception, for an overall prevalence of 2 per 10 000. When adjusted for sociodemographic characteristics, women with pelvic endometriosis had a consistently higher likelihood of bowel obstruction (odds ratio [OR] 2.6; 95% confidendence interval [CI] 2.3-3.00, P <0.01). In particular, intestinal endometriosis was associated with a 14.6-fold increased risk of bowel obstruction (95% CI 11.4-18.8, P <0.01), while rectovaginal endometriosis was associated with a 2.00-fold increased risk (95% CI 1.5-2.6, P <0.01). Pelvic endometriosis was significantly associated with adhesive bowel obstruction (adjusted OR: 3.2; 95% CI 2.6-3.9) and non-adhesive bowel obstruction (adjusted OR 2.4; 95% CI 2.0-2.8). The rates of endometriosis among women with or without intussusception were comparable.
Pelvic endometriosis, in particular rectovaginal and intestinal endometriosis is strongly associated with bowel obstruction, independent of the presence of intra-abdominal adhesions. We did not find any association between pelvic endometriosis and intussusception.
利用大型人群数据库评估子宫内膜异位症与肠梗阻或肠套叠的关联。
这是一项基于人群的研究，使用了 2005 年至 2014 年医疗保健成本和利用项目-全国住院患者样本（HCUP-NIS）的数据。我们研究了年龄在 18 至 55 岁之间、无炎症性肠病或癌症的女性。多变量逻辑回归用于检查子宫内膜异位症与肠梗阻之间的关联。
在符合纳入标准的 18427520 名女性中，96539 名经历过肠梗阻，总体患病率为 52/10000，3825 名经历过肠套叠，总体患病率为 2/10000。调整社会人口统计学特征后，患有盆腔子宫内膜异位症的女性肠梗阻的可能性始终更高（比值比[OR]2.6；95%置信区间[CI]2.3-3.00，P<0.01）。特别是肠子宫内膜异位症与肠梗阻的风险增加 14.6 倍相关（95%CI 11.4-18.8，P<0.01），而直肠阴道子宫内膜异位症与风险增加 2.00 倍相关（95%CI 1.5-2.6，P<0.01）。盆腔子宫内膜异位症与粘连性肠梗阻（调整 OR：3.2；95%CI 2.6-3.9）和非粘连性肠梗阻（调整 OR 2.4；95%CI 2.0-2.8）显著相关。有或没有肠套叠的女性中子宫内膜异位症的发生率相当。
盆腔子宫内膜异位症，特别是直肠阴道和肠子宫内膜异位症与肠梗阻密切相关，与腹腔内粘连的存在无关。我们没有发现盆腔子宫内膜异位症与肠套叠之间存在任何关联。
