论文部分内容阅读
目的分析总结直肠子宫内膜异位症病人漏诊误诊的原因。方法回顾性分析哈尔滨医科大学附属第三医院结直肠外科自1980年1月至2009年12月共收治的13例直肠子宫内膜异位症病人中漏诊误诊的12例的临床资料,结合文献总结其诊治情况。结果 13例病人中术前正确诊断仅1例,正确诊断率7.7%(1/13),其余12例属漏诊误诊,其中误诊3例,误诊率23.1%(3/13)。腹痛或盆腔痛是其最常见的症状,在9例病人中出现;2例病人有经期血便。在7例行妇科检查的病人中有4例(57.1%)可触及子宫直肠窝肿物,4例行肛诊检查的病人有3例(75.0%)有阳性发现。12例病人均行开腹手术,8例行节段性肠切除,4例行单纯直肠前壁结节切除。结论直肠子宫内膜异位症术前诊断困难,正确诊断率低,影像学检查是必不可少的检查手段;手术是治疗的首选方式。
Objective To analyze and summarize the causes of misdiagnosis in patients with rectal endometriosis. Methods The clinical data of 12 cases misdiagnosed in rectal endometriosis from January to December 2009 in Department of Colorectal Surgery, the Third Affiliated Hospital of Harbin Medical University were retrospectively analyzed. According to the literature The diagnosis and treatment. Results Of the 13 patients, correct diagnosis was performed in only 1 case, with a correct diagnosis rate of 7.7% (1/13). The remaining 12 cases were misdiagnosed as misdiagnosis, including 3 misdiagnosed cases, with a misdiagnosis rate of 23.1% (3/13). Abdominal or pelvic pain is its most common symptom, occurring in 9 patients; 2 patients have menstrual blood stools. In 7 gynecological examinations, 4 (57.1%) had palpable uterine rectal neoplasms, and 3 (75.0%) had positive findings in 4 patients who underwent anal examinations. All 12 patients underwent laparotomy, with segmental bowel resection in 8 patients and resection of anterior rectal wall in 4 patients. Conclusion Rectal endometriosis preoperative diagnosis difficult, the correct diagnosis is low, imaging is an essential means of examination; surgery is the preferred method of treatment.