宫颈子宫内膜异位症106例临床诊疗分析

杨君; 龙馨; 颜丽; 周德平

doi:10.16016/j.1000-5404.202008149

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宫颈子宫内膜异位症106例临床诊疗分析

临床医学 | 更新时间：2026-01-09

- 宫颈子宫内膜异位症106例临床诊疗分析
- Efficacy of 3 treatments for cervical endometriosis: clinical analysis of 106 cases
- 第三军医大学学报 2020年42卷第24期页码：2413-2418
- 作者机构：
  
  401147 重庆，重庆市妇幼保健院宫颈疾病诊治中心
- 作者简介：
  
  [杨君，E-mail：850495017@qq.comYANG Jun, E-mail: 850495017@qq.com
- 基金信息：
  
  重庆市科卫联合重点基金(2019ZDXM051)
- DOI：10.16016/j.1000-5404.202008149
  中图分类号： R181.32;R711.71
- 收稿：2020-08-15，
  
  修回：2020-10-14，
  
  纸质出版：2020-12-30
- 稿件说明：
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杨君, 龙馨, 颜丽, 等. 宫颈子宫内膜异位症106例临床诊疗分析[J]. 第三军医大学学报, 2020,42(24):2413-2418.

Jun YANG, Xin LONG, Li YAN, et al. Efficacy of 3 treatments for cervical endometriosis: clinical analysis of 106 cases[J]. Journal of Third Military Medical University, 2020, 42(24): 2413-2418.
杨君, 龙馨, 颜丽, 等. 宫颈子宫内膜异位症106例临床诊疗分析[J]. 第三军医大学学报, 2020,42(24):2413-2418. DOI： 10.16016/j.1000-5404.202008149.

Jun YANG, Xin LONG, Li YAN, et al. Efficacy of 3 treatments for cervical endometriosis: clinical analysis of 106 cases[J]. Journal of Third Military Medical University, 2020, 42(24): 2413-2418. DOI： 10.16016/j.1000-5404.202008149.

摘要

目的

评估3种方式治疗宫颈子宫内膜异位症的临床疗效。

方法

回顾性分析重庆市妇幼保健院宫颈疾病诊治中心2013年1月至2019年3月106例确诊为宫颈子宫内膜异位症患者的临床资料，按照患者选择的不同治疗方法分为3组：激光组(44例)、药物组(聚甲酚磺醛栓阴道上药，37例)、联合组(激光治疗联合口服达英-35片，25例)，统计分析评价其临床疗效。

结果

① 3组总有效率分别为93.18%(41/44)、78.38%(29/37)、96.00%(24/25)，组间比较差异有统计学意义(χ

=6.076，

0.05)。②各治疗组内比较：在激光组和联合组内，原有病灶面积大小对临床疗效的影响，差异无统计学意义(χ

激光

=-1.538，

0.05；χ

联合

=-1.239，

0.05)；药物组中病灶累及≤2个象限者，治愈率高于病灶累及＞2个象限者(χ

=-2.796，

0.01)。③各治疗组内比较，激光组内无其他部位子宫内膜异位症患者治愈率高于有合并其他部位子宫内膜异位症患者(

激光

=-2.124，

0.05)；药物组和联合组中临床疗效不受是否合并其他部位子宫内膜异位症影响，差异皆无统计学意义(

药物

=-1.337，

0.05；

联合

=-0.873，

0.05)。④术后6~12个月评估，联合组无复发；原有病灶面积及是否合并其他部位子宫内膜异位症对激光组复发率无影响(

0.05)；药物组内，病灶累及象限＞2个、合并有其他部位子宫内膜异位症患者复发率更高(

0.05)。

结论

治疗宫颈子宫内膜异位症应根据宫颈局部病灶面积及是否合并其他部位子宫内膜异位症，选择不同治疗方案。

Abstract

Objective

To evaluate the clinical efficacy of 3 treatments for cervical endometriosis.

Methods

Clinical data of 106 patients with cervical endometriosis treated in our center from January 2013 to March 2019 were collected and retr

ospectively analyzed. According to the treatments

they were assigned into yttrium aluminum garnet (YAG) laser group (

=44

laser group)

transvaginal administration of policresulen suppositories group (

=37

medication group) and YAG laser along with oral contraceptive group (

=25

Diane-35

combination group). The clinical efficacy and adverse effects were evaluated and compared among the 3 groups during the 6~12 months' follow-up.

Results

① The total effective rates were 93.18% (41/44)

78.38% (29/37) and 96.00% (24/25)

respectively

in the laser

medication and combination groups

with statistical difference among them (

Chi-

square=6.076

0.05). ② The original lesion size showed no effect on clinical efficacy both in the laser group (

Chi

-square=-1.538

0.05) and the combination group (

Chi

-square=-1.239

0.05). In the medication group

the patients with lesions involving ≤2 quadrants had a higher recovery rate than those with

2 quadrants (

Chi

-square=-2.796

0.01). ③ In the laser group

the recovery rate of the patients with simple cervical endometriosis was higher than that of those with other parts of endometriosis (

=-2.124

0.05). But

the rate was not affected by whether involving other parts or not in the medication (

=-1.337

0.05) and combination groups (

=-0.873

0.05). ④ During the follow-up of 6~12 months

no recurrence was found in the combination group. The size of original lesion and involvement of other parts had no effect on the recurrence rate in the laser group (

0.05). In the medication group

the patients with lesions of

2 quadrants or with other parts of endometriosis had higher recurrence rate (

0.05).

Conclusion

Size of cervical lesions and whether involved with other parts of endometriosis should be considered when choosing different treatment methods for cervical endometriosis.

关键词

Keywords

references

谢幸, 孔北华, 段涛.妇产科学[M].第9版.北京: 人民卫生出版社, 2018: 261-267.

XIE X, KONG B H, DUAN T. Obstetrics and gynecology[M]. Beijing: People's Health Press, 2018: 261-267.

张志胜, 刘毅智, 刘凤英.阴道镜图谱[M].第3版.北京: 人民卫生出版社, 2016: 59.

ZHANG Z S, LIU Y Z, LIU F Y. Colposcopy atlas[M]. Beijing: People's Health Press, 2016: 59.

葛彦欣, 王秀芹. 46例宫颈子宫内膜异位症的临床特征及防治[J].现代妇产科进展, 2011, 20(11): 917-918. DOI: 10.13283/j.cnki.xdfckjz.2011.11.023.

GE Y X, WANG X Q. Clinical features prevention and treatment of 46 cases of cervical endometriosis[J]. Prog Obstet Gynecol, 2011, 20(11): 917-918. DOI: 10.13283/j.cnki.xdfckjz.2011.11.023.

吴瑾, 贾英, 唐良萏.宫颈子宫内膜异位症23例临床分析[J].重庆医学, 2012, 41(18): 1830-1831, 1833. DOI: 10.3969/j.issn.1671-8348.2012.18.015.

WU J, JIA Y, TANG L D. Clinical analysis of 23 cases with cervical endometriosis[J].Chongqing Med, 2012, 41(18): 1830-1831, 1833. DOI: 10.3969/j.issn. 1671-8348.2012.18.015.

初虹, 余志英, 关嵩青, 等.宫颈环形电切术与冷刀锥切术治疗宫颈上皮内瘤变Ⅲ级的临床效果[J].中外医学研究, 2020, 18(2): 33-35. DOI: 10.14033/j.cnki.cfmr.2020.02.014.

CHU H, YU Z Y, GUAN S Q, et al . The clinical effect of cervical loop electrosurgical excision procedure and cold knife conization in the treatment of cervical intraepithelial neoplasia Ⅲ[J ] . Chin Foreign Med Res, 2020, 18(2): 33-35. DOI:10.14033/j.cnki.cfmr.2020.02.014.

RODRIGUEZ-URREG P, DULCEY-HORMIGA I, BARRERA-HERRERA L, et al . Endometriosis mimicking glandularatypia in a cervical cytology[J ] . J Cytol, 2017, 34(1): 61. DOI:10.4103/0970- 9371.197624.

许阡, 段华, 金佟, 等.宫颈子宫内膜异位症伴活动性阴道出血一例并文献复习[J].国际妇产科学杂志, 2019, 46(5): 549-551, 封3.

XU Q, DUAN H, JIN T, et al . Acute vaginal bleeding caused by cervical endometriosis: a case report and literature review[J ] . J Int Obstet Gynecol, 2019, 46(5): 549-551, 封3.

郭涛, 董雪, 石钢.宫腔镜成功治疗宫颈子宫内膜异位症巨大囊肿1例报告[J].四川大学学报(医学版), 2019, 50(1): 143. DOI: 10.13464/j.scuxbyxb. 2019.01.034.

GUO T, DONG X, SHI G.One case report of hysteroscopy in the treatment of giant cyst of cervical endometriosis[J]. J Sichuan Univ Med Sci Ed, 2019, 50(1): 143. DOI: 10.13464/j.scuxbyxb. 2019.01.034.

WANG Y, ZHUGE Y Y, ZHANG Y, et al . Massive vaginal hemorrhage caused by cervical endometriosis[J ] . Taiwan J Obstet Gynecol, 2018, 57(6): 903-905. DOI: 10.1016/j.tjog.2018.10.026.

李小芬.宫颈炎性疾病物理治疗后并发宫颈子宫内膜异位症的临床分析[J].基层医学论坛, 2018, 22(32): 4523-4524. DOI: 10.19435/j.1672- 1721.2018.32.013.

LI X F. Clinical analysis of cervical endometriosis after physical therapy for cervicitis[J]. Med Forum, 2018, 22(32): 4523-4524. DOI: 10.19435/j.1672- 1721.2018.32.013.

王茹, 赵剑虹.去氧孕烯炔雌醇预防宫颈糜烂患者经物理治疗后宫颈子宫内膜异位发生的临床分析[J].中国性科学, 2015, 24(5): 32-34. DOI: 10.3969/j.issn.1672-1993.2015.05.012.

WANG R, ZHAO J H. Effect of desogestrel and ethinylestradiol in preventing cervical endometriosis[J]. Chin J Hum Sex, 2015, 24(5): 32-34. DOI: 10.3969/j.issn.1672-1993.2015.05.012.

刘美霞, 田桂林.聚甲酚磺醛溶液宫颈上药治疗慢性子宫颈炎Ⅱ~Ⅲ度糜烂样改变的临床疗效观察[J].中国实用医药, 2020, 15(2): 132-134. DOI: 10.14163/j.cnki.11-5547/r.2020.02.060.

LIU M X, TIAN G L. Clinical observation on the curative effect of cervical application of poly (cresolsulfonaldehyde) solution in the treatment of chronic cervicitis[J]. Chin Pract Med, 2020, 15(2): 132-134. DOI: 10.14163/j.cnki.11-5547/r.2020.02.060.r.2020.02.060.

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