Corwin E J
Family Nurse Practitioner Program, Pennsylvania State University, University Park, USA.
Nurse Pract. 1997 Oct;22(10):35-8, 40-2, 45-6, passim; quiz 56-7.
Endometriosis is the presence of endometrial tissue outside of the uterine cavity, most commonly surrounding the ovaries and fallopian tubes. It is relatively common disorder in reproductive-age women and is associated with significant pain and morbidity. In most cases, the spread of extrauterine endometrial tissue appears to result from retrograde menstruation and capillary or lymph dissemination. Endometrial cells implanted ectopically respond to cyclical changes in estrogen and progesterone with proliferation and secretion. Their presence in extrauterine areas can initiate immune and inflammatory responses that lead to pain and peritoneal adhesions, and may interfere with fertility. Diagnosis is based on the occurrence of cyclical symptoms and surgical validation via laparoscopy or laparotomy. Treatment is aimed at alleviating pain and preventing complications. Most treatments work by reducing estrogen levels and/or menstrual cycling. A primary practitioner must understand not only the medical aspects of this disease, but the enormous social and psychologic costs as well.
子宫内膜异位症是指子宫内膜组织出现在子宫腔外，最常见于卵巢和输卵管周围。这是育龄女性中较为常见的一种疾病，与严重的疼痛和发病率相关。在大多数情况下，子宫外子宫内膜组织的扩散似乎是由逆行性月经以及毛细血管或淋巴扩散引起的。异位植入的子宫内膜细胞会随着雌激素和孕激素的周期性变化而发生增殖和分泌。它们在子宫外区域的存在可引发免疫和炎症反应，导致疼痛和腹膜粘连，并可能影响生育能力。诊断基于周期性症状的出现以及通过腹腔镜检查或剖腹手术进行的手术验证。治疗旨在减轻疼痛并预防并发症。大多数治疗方法通过降低雌激素水平和/或月经周期来起作用。一名初级从业者不仅必须了解这种疾病的医学方面，还必须了解其巨大的社会和心理成本。
