宫颈后子宫内膜异位症的临床和形态学特征

K. AlmovaIndira, G. KhilkevichElena, Asaturova Alexandra, Zaitsev Nikon, D. ChupryninVladimir
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摘要

目的:探讨宫颈后子宫内膜异位症的临床和形态学特点。材料与方法:在俄罗斯卫生部V.I. Kulakov院士命名的国家妇产科和围产期医学研究中心,于2016年至2018年对120例宫颈后子宫内膜异位症患者进行检查和手术。患者分为4个亚组。根据妇科检查(双侧及直肠阴道检查)、超声、MRI、腹腔镜检查及活检材料组织学检查,确定宫颈后子宫内膜异位症的程度。研究结果:宫颈后子宫内膜异位症临床表现多样。外生殖器子宫内膜异位症患者出现高频率的疼痛综合征(盆腔疼痛、痛经、性交困难、痛经)和不孕症是该病的重要诊断标准,也是确定腹腔镜手术适应症的重要依据。子宫内膜异位症的临床表现在形态学上可以表现为原位因子、氧化应激、细胞增殖、血管生成、神经节破坏和/或增生以及异位的神经周围生长。结论:RCA患者需要进行全面检查,最后阶段为腹腔镜检查,切除所有可见的子宫内膜异位灶,消除骨盆粘连,然后进行异位灶形态学研究。
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Clinical and Morphological Features of Retrocervical Endometriosis
Objective: To study the clinical and morphological features in patients with retrocervical endometriosis. Material and Methods: In National Medical Research Center of Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov, Ministry of Health of Russia, In the period from 2016 to 2018, 120 patients with retrocervical endometriosis were examined and operated on. Patients were divided into 4 subgroups. The extent of retrocervical endometriosis was established according to the gynecological examination (bimanual and rectovaginal examination), ultrasound, MRI, laparoscopy and histological examination of biopsy material. The Results of the Study: clinical manifestations of retrocervical endometriosis are diverse. High frequency of pain syndrome (pelvic pain, dysmenorrhea, dyspareunia, dyschesia) and infertility in women with external genital endometriosis is an important diagnostic criterion for the disease and determine the indications for laparoscopy. Clinical manifestations of endometriosis, morphologically, can be characterized by in situ factors, oxidative stress, cell proliferation, angiogenesis, destruction and / or proliferation of the nerve ganglia and perineural growth of heterotopies. Conclusion: patients with RCA need a comprehensive examination, the final stage of which is laparoscopy, removal of all visible endometriotic foci, elimination of adhesive adhesions in the pelvis, followed by morphological study of ectopic foci.
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