青春期子宫内膜异位症研究进展.docVIP

青春期子宫内膜异位症研究进展 　　【摘要】虽然近年来对子宫内膜异位症（EM）研究的文献报道不断增加，但其发病机制、危险因素到疾病的治疗，进展仍不清楚。正因为其“神秘性”，病情进展性，对青春期发病的青少年更是关系到其今后生育及对生活质量的影响，故近年来对青春期子宫内膜异位症的研究不断增加。青春期子宫内膜异位症其临床症状不典型，加强对疾病的认识，早发现、早干预、早治疗具有重要意义。识别那些可能发病，病情进展的或有再发风险的高风险人群尤为重要。目前研究多有其不可规避的缺陷，如回顾性偏倚，样本量小等，并未明确肯定，手术后应常规药物治疗或在青春期人群应药物介入以预防疾病进展及今后可能出现的不孕。 　　【关键词】青春期；子宫内膜异位症；发病机制；临床特点；进展与复发 　　A new challenge of adolescent endometriosisLIU Yabo. Department of gynecology. Tianjin center of Obstetrics and Gynecology hospital，Tianjin 300100，China 　　【Abstract】The etiology of endometriosis and the risk of development in this disease are not very certain，whereas the study reported are increasing.Endometriosis in the adolescent has， in recent years， been discovered to be a challenging problem in gynaecology ，because it has affected the daily life and severely compromised fecundability. Adolescents with endometrioma experience more frequent pain， but other clinical characteristics are similar to adults. The diagnosis of endometriosis and intervention at an early stage before severe lesions develop are very important. In addition， identifying patients who are at increased risk for recurrent disease is of clinical importance. These issues of disease have been the focus of recent studies in adolescent endometriosis. However， all these studies have varying limitations some of which include small sample size，retrospective in nature. The literature does not yet confirm that postoperative medical treatment should be routinely prescribed or that intervening in the adolescent population prevents disease progression or long-term sequelae such as adult infertility. 　　【Key words】Adolscence； Endotriosis； Pathogenesis； Clinical characterics； Development and recurrence 　　【中图分类号】R711.11【文献标志码】A 　　子宫内膜异位症是指具有生长功能的子宫内膜组织出现在子宫腔被覆黏膜以外的其他部位，病理表现为子宫体外出现内膜腺体和内膜间质。现在虽然对其研究的文献报道不断增加，但在诸多方面对于我们还是一种颇具神秘感的疾病。对青春期子宫内膜异位症中这些问题的认识处理更是尤为重要。近年来这方面的研究日益受到关注，下面就对相关文献做一综述。 　　1发病机制 　　世界卫生组织将青春期年龄范围定义为10～24岁，我国为10～20岁。Marc报道了5例月经初潮前诊断此病的患儿，其中最小的8.5岁。随后又有相应的病例报道。 　　Batt等认为