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患有输卵管卵巢脓肿和子宫内膜异位症的女性的临床特征、治疗状况和并发症:一项回顾性研究。

Clinical characteristics, treatment status and complications in women with tube ovarian abscess and endometriosis: a retrospective study.

机构信息

Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, 100044, China.

Gynecological Oncology Center, Peking University People's Hospital, Beijing, 100044, China.

出版信息

BMC Womens Health. 2021 Mar 18;21(1):109. doi: 10.1186/s12905-020-01119-x.

Abstract

BACKGROUND

The aim of our present study was to investigate the clinical characteristics, treatment status and complications in women with endometriosis (EM) and tube ovarian abscess (TOA) to determine the possible association between TOA and EM.

METHODS

Medical records were used to analyze the clinical characteristics, treatment and complications. Twenty women who were diagnosed with TOA with EM were compared with 93 women diagnosed as having TOA without EM between January, 2008 and December, 2018.

RESULTS

In this study, TOA patients with EM were significantly more likely to have a lower age range (20-39 years) than the non-EM group [11/20 (55.0%) vs 27/93 (29.0%)]. In addition, TOA patients with EM were associated with a significantly lower rate of parity [11/20 (55.0%) vs 75/93 (80.6%)], higher rates of infertility [8/20(40%) vs 0/93(0%)] and a significantly lower incidence of elevated blood platelet counts [5/20 (25%) vs 43/93 (46.2%)]. Furthermore, women with EM had greater blood loss (347 ± 445.77 vs 204.67 ± 289.46) and an increased complication rate [3/20(15%) vs 0/93(0%)]. Among the 3 patients who had complications in the EM group, 2 patients had septic shock and 1 patient had intestinal obstruction. And 1 case who had septic shock followed by IVF treatment. There was no significance difference on other factors.

CONCLUSIONS

The present study indicated that EM did not increase the difficulty and time of treatment in patients with TOA, but increased bleeding during surgery and serious complications. It is suggested that doctors should pay more attention to postoperative treatment and nursing in women with TOA and EM, especially those who have a history of recent infertility treatment and related procedures.

摘要

背景

本研究旨在探讨子宫内膜异位症(EM)合并输卵管卵巢脓肿(TOA)患者的临床特征、治疗现状及并发症,以明确 TOA 与 EM 之间的可能关联。

方法

采用病历资料分析法,对 2008 年 1 月至 2018 年 12 月期间诊断为 TOA 合并 EM 的 20 例患者与同期诊断为单纯 TOA 的 93 例患者的临床特征、治疗方法及并发症进行比较。

结果

本研究中,EM 合并 TOA 患者的年龄范围明显小于非 EM 组(20-39 岁:11/20[55.0%] vs 27/93[29.0%])。此外,EM 合并 TOA 患者的生育史更差(无生育史:11/20[55.0%] vs 75/93[80.6%])、不孕率更高(8/20[40.0%] vs 0/93[0%])、血小板计数升高发生率更低(5/20[25.0%] vs 43/93[46.2%])。而且,EM 合并 TOA 患者术中出血量更大(347±445.77 vs 204.67±289.46)、并发症发生率更高(3/20[15.0%] vs 0/93[0%])。EM 组的 3 例并发症患者中,2 例为感染性休克,1 例为肠梗阻,1 例因感染性休克后行 IVF 治疗。其他因素无显著性差异。

结论

本研究表明,EM 并不增加 TOA 患者的治疗难度和时间,但会增加术中出血量和严重并发症。建议医生对 TOA 合并 EM 患者,尤其是近期有不孕治疗及相关手术史的患者,应更加重视术后治疗和护理。

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本文引用的文献

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Rethinking mechanisms, diagnosis and management of endometriosis.重新思考子宫内膜异位症的发病机制、诊断和治疗。
Nat Rev Endocrinol. 2019 Nov;15(11):666-682. doi: 10.1038/s41574-019-0245-z. Epub 2019 Sep 5.
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[Clinical analysis of pelvic abscess with endometriosis].[子宫内膜异位症合并盆腔脓肿的临床分析]
Zhonghua Fu Chan Ke Za Zhi. 2017 Mar 25;52(3):164-167. doi: 10.3760/cma.j.issn.0529-567X.2017.03.005.

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