【摘要】 目的:总结输尿管子宫内膜异位症的临床、病理特点及采用不同手术方法治疗的效果。方法:回顾分析6例输尿管子宫内膜异位症患者的临床资料、术后随访资料,并对这些结果进行对比分析。结果:6例患者均为单侧发病、均为下1/3段,3例术前病理确诊,行病变段切除、输尿管膀胱再植术,术后随访1～5年,均无复发梗阻;另外3例术前未确诊,行病变段冷刀内切开+双重双J管内引流2～3个月,拔管后随访过程中,1例失访,另外2例分别于6和11个月复发梗阻,改为病变段切除、输尿管膀胱再植术,再随访1～3年,未发现复发梗阻。6例术后2周始均结合药物内分泌治疗3～6个月,其中3例口服丹那唑0.2g Bid,3例皮下注射康士得3.6mg 1次/月。结论:输尿管镜下冷刀内切开虽然创伤较小,但不能完全去除异位的子宫内膜,梗阻复发率较高,故临床上以采用病变段切除、输尿管膀胱再植术,结合内分泌治疗为妥。更多还原

【Abstract】 Objective:To summarize the clinical and pathological characteristics of ureteral endometriosis and the prognosis after different treatment.Methods:Reviewed retrospectively and analyzed the clinical and post-operational follow-up data of 6 cases of ureteral endometriosis.Results:All the 6 cases of ureteral endometriosis were all to take place at the lower 1/3 of one-side.3 cases were to be made a definite diagnosis before operation by pathology. They underwent segmental ureterectomy and ureteral reimplantation.Obstruction was not found in the next 1 to 5 years.The other 3 cases were not considered before operation,the patients were performed ento-slit with cryoprobe under ureteroscope at diseased region and putting in two double-J ducts.The ducts were pulled out after 2 to 3 months.1 case was out of the follow-up after pulling out.While obstruction was found in the other 2 cases after 6,11 months.Those 2 cases were performed segmental ureterectomy and ureteral reimplantation then.No relapse was found in the next 1 to 3 years.All of the 6 cases combined the drug with the endocrinotherapy after 2 weeks of operation for 3 6 months,3 cases took danazol 0.2 Bid,the other 3 cases took subcutaneous injection of Casodex 3.6 mg one time per month.Conclusions:Though ento slit under ureteroscope has less injury,it can not remove the endometrium completely but resolve the obstruction temporary,and with the high relapse rate of obstruction, so the clinical treatment of ureteral endometriosis should be performed segmental ureterectomy,ureteral reimplantation and endocrinotherapy.更多还原