摘要
目的 研究腹腔镜下盆腔子宫内膜异位症 (EM )的各种外观形态表现及相应的组织学特点。方法 对 88例不孕症患者在腹腔镜二氧化碳人工气腹下进行盆腔检查 ,对典型或不典型子宫内膜异位病损拍照记录 ,病损部位行组织学检查或行内凝热 -色试验 (heat -colourtest,HCT)。结果 腹腔镜下发现的盆腔EM外观表现有以下类型 :①典型病损 :包括色素型病损、出血型病损及腺体样结构。②不典型病损 :包括水泡病损、微细病损及血管增生病损。③隐匿性病损 :在腹腔CO2 充气 (约 30分钟 )后方可显示出点状或斑片状出血灶。④疤痕性病损 :白色斑块及腹膜缺损。 39例盆腔EM患者的 44处病损行活组织检查 ,2 8处见子宫内膜上皮、腺体和间质或含铁血黄素 ,组织学检查诊断EM的阳性率达 6 4% ,未行组织学检查的上述病损HCT均阳性。结论 盆腔EM的形态具多样性 ,腹腔镜放大作用及CO2 气腹有助于不典型和隐匿性病损的发现和显示。
Objective To study the appearances of various endometriotic lesions under laparoscope and corresponding histological characteristics.Methods Pelvic peritoneum of 88 infertile cases were examined by laparoscopy under CO 2-tympanites.The pelvic endometriosis(EM) lesions were photographed,and then further examined by histological method or heat-color test(HCT).Results All the pelvic EM lesions could be classified visually into four types-typical,non-typical,latent and lesion of scars.Bleeding spots appeared on latent lesion after 30 minutes of CO 2-tympanites,and were positive in HCT.Of 63 cases who were diagnosed as pelvic EM,39 patients were examined by biopsy at 44 lesion sites,28 lesion sites were found epithelium of endometrium,gland and interstitium.Positive ratio of histological diagnosis for EM was 64%.Conclusion Pelvic EM was diversified in form.Laparoscopic magnification and CO 2-tympanites would help to find non-typical or latent lesion.Histological evidence indicated that diversified appearance of EM was related to their various developing stages of the lesion and its activity.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2000年第12期729-731,I001,共4页
Chinese Journal of Practical Gynecology and Obstetrics
