青春期子宫内膜异位症诊治的研究进展

doi:10.12280/gjfckx.20230121

摘要/Abstract

摘要：

子宫内膜异位症（endometriosis，EMs）指子宫内膜腺体和间质出现在子宫腔以外部位的一类妇科疾病，可影响女性整个生命周期。青春期EMs作为一种特殊年龄段的EMs，正日益受到关注。青春期EMs发病的主要危险因素包括遗传易感性、梗阻性生殖道畸形与内源性雌激素升高等。其发病机制假说众多，包括经血逆流学说、体腔上皮化生、血源性扩散、淋巴扩散、新生儿子宫出血和免疫学学说等。青春期EMs的诊断需综合临床症状、体征、血清学、影像学、手术及病理组织学结果。个性化的内外科治疗被认为是缓解症状、抑制疾病进展、保护未来生育力的最有效的治疗策略。综述青春期EMs的危险因素、发病机制、临床表现及诊治方式，以期为临床医生对该病的认识和诊治提供参考。

关键词: 子宫内膜异位症, 青春期, 危险因素, 诊断, 治疗, 病因

Abstract:

Endometriosis (EMs) is a group of gynecologic disease defined by the presence of endometrial glandular epithelium and stroma outside the uterine lining. Recent studies suggest that EMs can affect women throughout their life cycle. Adolescent EMs is a special type of EMs which has attracted increasing attention in recent years. Among the most important risk factors for adolescent EMs are include genetic predisposition, co-presence of obstructive Müllerian anomalies, and higher levels of endogenous estrogens. There are many hypotheses for the pathogenesis of adolescent EMs, including retrograde menstruation theory, somatic epithelial metaplasia, hematogenous spread, lymphatic spread, neonatal uterine bleeding, immunologic theory and so on. Diagnosis depends on clinical symptoms, body sign, serology, imaging, surgery and pathology. Individualized medical and surgical treatment is considered the most effective strategy to relieve symptoms, inhibit disease progression, and protect future fertility. This article reviews the risk factors, pathogenesis, clinical manifestations, diagnosis and treatment of adolescent EMs, in order to provide clinicians with a reference for the understanding and treatment of this disease.

Key words: Endometriosis, Puberty, Risk factors, Diagnosis, Therapy, Etiology

潘永超, 汪银锋, 毛晶霞, 吴瑞瑾. 青春期子宫内膜异位症诊治的研究进展[J]. 国际妇产科学杂志, 2023, 50(4): 466-471.

PAN Yong-chao, WANG Yin-feng, MAO Jing-xia, WU Rui-jin. Research Progress of Diagnosis and Treatment of Adolescent Endometriosis[J]. Journal of International Obstetrics and Gynecology, 2023, 50(4): 466-471.

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