【摘要】 目的:分析腹膜型、卵巢型及混合型子宫内膜异位症临床特点,探讨不同类型可能的发病机制。方法:统计中国医科大学附属盛京医院2011年12月至2012年12月经手术证实为盆腔子宫内膜异位症的446例患者,根据不同类型将所有患者分为:腹膜型组137例(30.7%)、卵巢型组48例(10.8%)、混合型组261例(58.5%)3组,比较各组间临床特点的差异。结果:腹膜型和混合型以双侧多见(62.8%,62.1%),卵巢型以单侧多见(81.3%)(P<0.05);腹膜型易于其他手术时同时发现(94.9%),卵巢型和混合型多以子宫内膜异位症为指征行手术(95.8%,100.0%)(P<0.05);腹膜型多无症状(93.4%),卵巢型及混合型更易引起痛经(75.0%及67.0%)(P<0.05);腹膜型及卵巢型多存在于早期(100.0%及85.4%),混合型多存在于晚期(65.5%)(P<0.05)。结论:经血逆流导致的内膜种植学说可能是子宫内膜异位症发病机制的基础学说,腹膜型子宫内膜异位症可能为盆腔子宫内膜异位症的先期病变。更多还原

【Abstract】 Objective: To investigate the clinical characteristics and potetial pathogenesis of pelvic endometriosis,peritoneal endometriosis,ovarian endometriosis and mixed endometriosis. M ethods: 446 patients with surgically confirmed endometriosis in the Shengjing Hospital of China Medical University,from December 2011 to December 2012,were divided into three groups: ovarian endometriosis( 10. 8%),peritoneal endometriosis( 30. 7%),and mixed endometriosis( 58. 5%). Prospective statistic was conducted to compare the clinical characteristics of three groups. Results: Peritoneal endometriosis and mixed endometriosis are mainly bilateral( 62. 8% and62. 1%,respectively),while ovarian endometriosis is unilateral( 81. 3%)( P < 0. 05). Most peritoneal endometriosis are easily found in the other gynecology and obstetrics operation( 94. 9%),while ovarian and mixed endometriosis undergo the operation due to endometriosis( 95. 8% and 100. 0%,respectively)( P < 0. 05). Peritoneal endometriosis show little symptom( 93. 4%). In contrast,ovarian and mixed endometriosis patients were more likely to suffer dysmenorrhea( 75. 0% and 67. 0%,respectively)( P < 0. 05). Peritoneal and ovarian endometriosis were found to be the early stage of this disease( 100. 0% and 85. 4%,respectively),while mixed lesion was at advanced stage( 65. 5%)( P < 0. 05). Conclusions: Implantation theory could be the basic pathogenesis theory of endometriosis,which proposes that endometrial cells are refluxed and implanted during menstruation. Peritoneal endometriosis may be the precursor lesion of pelvic endometriosis.更多还原