输尿管子宫内膜异位症9例临床分析

发布时间：2018-06-05 11:55

本文选题：输尿管 + 子宫内膜异位症　；参考：《实用妇产科杂志》2015年07期

【摘要】：目的:探讨输尿管子宫内膜异位症患者的临床诊断和治疗方法。方法:回顾性分析9例术后病理检查证实为输尿管子宫内膜异位症患者的临床资料。结果:9例中8例有痛经史。泌尿系统超声检查9例均有中重度肾积水;5例接受了CT检查,均提示患侧输尿管上段扩张伴患侧肾积水。3例腰麻下行输尿管镜检查,1例活检明确为输尿管子宫内膜异位症。4例术前诊断为子宫内膜异位症的患者采用药物治疗,肾积水没有得到明显改善。9例患者因输尿管梗阻、肾积水行手术治疗,2例行输尿管端端吻合术,6例行输尿管膀胱再吻合术,1例行肾切除;3例同期行患侧附件切除。结论:输尿管子宫内膜异位症诊断困难,在临床上对于不明原因输尿管梗阻、肾积水,且有痛经病史的患者应高度怀疑输尿管子宫内膜异位症可能,进一步的影像学检查或输尿管镜检查有助于诊断。药物治疗作用有限,明确中、重度输尿管梗阻者应积极手术治疗。
[Abstract]:Objective: to investigate the clinical diagnosis and treatment of ureteral endometriosis. Methods: the clinical data of 9 cases of ureteral endometriosis confirmed by pathological examination were retrospectively analyzed. Results among 9 cases, 8 cases had dysmenorrhea history. Nine patients with moderate and severe hydronephrosis were examined by CT. All of them suggested that ureteroscopy was performed in 3 patients with upper ureteral dilatation and hydronephrosis under spinal anesthesia. One case of ureteral endometriosis confirmed by biopsy was treated with drugs in 4 cases diagnosed as endometriosis before operation. 9 cases of hydronephrosis were not improved because of ureteral obstruction, 2 cases of hydronephrosis were treated by ureteral end-to-end anastomosis and 6 cases by uretero-cystostomy and 1 case by nephrectomy and 3 cases by appendage resection. Conclusion: the diagnosis of ureteral endometriosis is difficult. Patients with unexplained ureteral obstruction, hydronephrosis and dysmenorrhea should be highly suspected of ureteral endometriosis. Further imaging or ureteroscopy is helpful in the diagnosis. The effect of drug therapy is limited. It is clear that the patients with severe ureteral obstruction should be treated actively.
【作者单位】：福建医科大学附属三明第一医院;
【分类号】：R711.71

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