Liang C C, Soong Y K, Ho Y S
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi. 1995 Dec;18(4):315-21.
With the aim of determining an effective therapy for adolescent women with endometriosis, the authors analyzed the results of laparotomy performed on 16 cases of female teenagers over a seven-year period. All patients, whose average age of menarche is 12.8, were diagnosed with endometriosis between two months and nine years after the menarche, with an average interval of 5.2 years. The chief symptoms are dysmenorrhea, pelvic pain and abdominal fullness. Of the three patients of unicornuate uterus with rudimentary horn, endometriosis was found only involving the adnexa on the side of the rudimentary horn, two of the three patients had absence of affected side kidney. Conservative operation including six cases of salpingo-oophorectomy and 10 cases of ovarian cystectomy were chosen followed by danazol treatment. One year to seven years after surgical treatment, two patients required subsequent conservative operation for recurrence of endometriosis and two other patients resumed dysmenorrhea. Two married women became pregnant 5 and 10 months after surgical and medical therapy respectively. In conclusion, adolescent endometriosis may occur around five years after menarche and an obstructive uterine anomaly, enhancing retrograde menstruation, increases the occurrence rate. The symptoms and treatment of endometriosis in teenage group do not really differ from that in the older women. In the treatment of endometriosis and for the prevention of recurrence, it is recommended to give three to six months of danazol after surgical treatment.
为确定治疗青春期子宫内膜异位症妇女的有效疗法,作者分析了7年间对16例少女行剖腹手术的结果。所有患者初潮平均年龄为12.8岁,在初潮后2个月至9年被诊断为子宫内膜异位症,平均间隔5.2年。主要症状为痛经、盆腔疼痛和腹部胀满。在3例单角子宫合并残角的患者中,子宫内膜异位症仅累及残角侧附件,3例中有2例患侧肾脏缺如。选择保守手术,包括6例输卵管卵巢切除术和10例卵巢囊肿切除术,术后给予达那唑治疗。手术治疗后1至7年,2例患者因子宫内膜异位症复发需再次行保守手术,另外2例患者痛经复发。2例已婚妇女分别在手术和药物治疗后5个月和10个月怀孕。总之,青春期子宫内膜异位症可能在初潮后约5年发生,梗阻性子宫异常会增加经血流向盆腔,从而提高发病率。青少年组子宫内膜异位症的症状和治疗与年长女性并无真正差异。在子宫内膜异位症的治疗及预防复发方面,建议术后给予3至6个月的达那唑治疗。