直肠子宫内膜异位症的诊断和手术治疗.pdfVIP

, 1997, . 35, . 3 1·70 · Ch in J Surg M arch V o l N o 直肠子宫内膜异位症的诊断和手术治疗 刘福坤　周珊英　苏延华　顾秋善　李国立 　　摘要　作者报告了26 例直肠子宫内膜异位症的诊断和手术治疗的经验。该病在临床症状、体征等 方面易与直肠癌相混淆, 易引起误诊和误治, 但在病史上有其特点, 即直肠刺激征、胀痛或便血, 常在月 经前后加重。便血在月经期多见。直肠指检和妇科检查, 直肠触及的肿块多位于粘膜下, 与阴道壁和宫颈 粘连。直肠镜检查直肠粘膜病变较轻, 仅为充血糜烂或息肉状隆起。组织病理学检查为慢性炎症表现。手 术适应证为保守治疗无效、症状明显、影响正常生活者; 病灶小者行局部肠壁楔形切除, 病灶大而深, 位 置低者可以行前切除吻合术。本组局部切除 16 例, 前切除吻合术 10 例。术后症状消失者 21 例, 症状改 善者 5 例。2 例 5 年后症状复发, 行再次手术后恢复。 关键词　子宫内膜异位症　　直肠　　诊断, 外科手术 The diagnosis and surg ical treatm en t in rectal endom etr iosis L iu F ukun , Z hou S hany ing , S u Y anhua, et . , 210002. al N anj ing General H osp ital of P eop le ’s L iberation A rm y N anj ing Abstract　F rom Jun 1975 to M ar 1995, 26 cases of endom etrio sis in the rectum (R E ) w ere adm it . 16 10. 21 ted L ocal rsection w as perfo rm ed in and D ixon’s operation in T he result show ed cases w ere symp tom atically cured and 5 w ith rem ission. 2 cases w ere reoperated because of recurrence in 5 years . . after the first operation and cured R E is difficult in distiguish ing from rectal cancer It is characterized , , . by tenesm us bursting pain hem atochezia in young and m iddle aged w om en during periods T he diagno sis can be m ade by tipycal h isto ry and vaginal exam ination, rectal exam ination, barium enem a, p rocto scopy and so on. T he indications of operation include severe cl