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腹腔镜检查女性输卵管子宫内膜异位症的诊断与治疗:来自一家医院的病例系列

Diagnosis and treatment of tubal endometriosis in women undergoing laparoscopy: A case series from a single hospital.

作者信息

Jiao Hai-Ning, Song Wei, Feng Wei-Wei, Liu Hua

机构信息

Department of Obstetrics and Gynecology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.

出版信息

World J Clin Cases. 2022 Nov 26;10(33):12136-12145. doi: 10.12998/wjcc.v10.i33.12136.

Abstract

BACKGROUND

Tubal endometriosis (TEM) is a category of pelvic endometriosis (EM) that is characterized by ectopic endometrial glands and/or stroma within any part of the fallopian tube. The fallopian tubes may be a partial source of ovarian endometriosis (OEM). TEM is difficult to diagnose during surgery and is usually detected by pathology after surgery.

AIM

To provide a clinical basis for the diagnosis and treatment of TEM.

METHODS

In this study, the data of 30 patients who underwent laparoscopic salpingectomy due to various gynecological diseases and had pathological confirmation of TEM at our hospital were retrospectively analyzed, and the clinical basis for the diagnosis and treatment of TEM was evaluated.

RESULTS

Among 1982 surgical patients, 30 met the study criteria. Among those, 6 patients had a history of infertility, 12 patients had a history of artificial abortion, 13 patients had a history of cesarean section, 1 patient had a history of tubal ligation, 4 patients had an intrauterine device, and 22 patients had hydrosalpinx. Sixteen patients (53.33%) conceived naturally and gave birth to healthy babies. Pathology showed that only 2 patients had TEM without any other gynecological diseases, while the others all had simultaneous diseases, including 26 patients with EM at other pelvic sites.

CONCLUSION

The final diagnosis of TEM depends on pathological examination since there are no specific clinical characteristics. The rate of TEM combined with EM (especially OEM) was higher than that of other gynecological diseases, which indicates that TEM is related to OEM.

摘要

背景

输卵管子宫内膜异位症(TEM)是盆腔子宫内膜异位症(EM)的一种类型,其特征是输卵管任何部位存在异位的子宫内膜腺体和/或间质。输卵管可能是卵巢子宫内膜异位症(OEM)的部分来源。TEM在手术中难以诊断,通常在术后通过病理检查发现。

目的

为TEM的诊断和治疗提供临床依据。

方法

本研究回顾性分析了我院30例因各种妇科疾病接受腹腔镜输卵管切除术且病理确诊为TEM的患者的数据,评估TEM诊断和治疗的临床依据。

结果

在1982例手术患者中,30例符合研究标准。其中,6例有不孕史,12例有人工流产史,13例有剖宫产史,1例有输卵管结扎史,4例有宫内节育器,22例有输卵管积水。16例患者(53.33%)自然受孕并生下健康婴儿。病理显示,仅2例患者有TEM且无任何其他妇科疾病,其他患者均同时患有其他疾病,包括26例其他盆腔部位的EM。

结论

由于TEM没有特定的临床特征,其最终诊断依赖于病理检查。TEM合并EM(尤其是OEM)的发生率高于其他妇科疾病,这表明TEM与OEM有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5310/9724517/63beb71aa07e/WJCC-10-12136-g001.jpg

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