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目的:探讨子宫内膜异位症(EM s)中子宫内膜息肉的发病率。方法:对1998年1月~2005年2月期间女性不孕症门诊诊治的308例不孕症患者进行回顾性分析,按照病因分为3组,EM s组94例,按照美国生殖学会分类法标准(AFS分期法)分为4期,其中Ⅰ期27例,Ⅱ期22例,Ⅲ期26例,Ⅳ期19例,慢性盆腔炎组98例,正常盆腔组116例。慢性盆腔炎、正常盆腔为对照组。子宫内膜异位症和慢性盆腔炎均经腹腔镜或开腹手术确诊,正常盆腔经腹腔镜证实,子宫内膜息肉经宫腔镜检查后病理证实。对3组不孕症和不同期别的EM s患者子宫内膜息肉的发生率进行比较。结果:EM s组发现子宫内膜息肉20例(21.3%),慢性盆腔炎组4例(4.1%),正常盆腔4例(3.4%),EM s组子宫内膜息肉的发生率显著高于对照组(P<0.05),不同期别的EM s子宫内膜息肉的发生率没有显著差异(P>0.05)。结论:对于明确诊断的EM s患者,行经阴道超声(TVS)注意排除宫腔占位,如发现宫腔占位,需行宫腔镜检查。反之,对于TVS或宫腔镜提示子宫内膜息肉的患者,可放宽腹腔镜检查指征,以明确是否有EM s存在。
Objective: To investigate the incidence of endometrial polyps in endometriosis (EM s). Methods: A retrospective analysis of 308 infertility patients diagnosed as female infertility during the period from January 1998 to February 2005 was divided into 3 groups according to the cause, and 94 patients were classified as EM s. According to the American Society of Reproductive Societies classification The standard (AFS staging method) was divided into four stages, of which 27 cases were stage Ⅰ, 22 cases were stage Ⅱ, 26 cases were stage Ⅲ, 19 cases were stage Ⅳ, 98 cases were chronic pelvic inflammation and 116 cases were normal pelvic. Chronic pelvic inflammatory disease, normal pelvic control group. Endometriosis and chronic pelvic inflammatory disease were confirmed by laparoscopy or laparotomy, normal pelvic confirmed by laparoscopy, endometrial polyps confirmed by pathology after hysteroscopy. The incidence of endometrial polyps among 3 groups of infertility and different stages of EM s was compared. Results: 20 cases (21.3%) of endometrial polyps were found in EM s group, 4 cases (4.1%) in chronic pelvic inflammatory disease group and 4 cases (4%) in normal pelvic cavity. The incidence of endometrial polyps in EM s group was significantly higher than that in endometrial polyps In the control group (P <0.05), there was no significant difference in the incidence of EM s endometrial polyps at different stages (P> 0.05). CONCLUSIONS: For clear diagnosis of EM s patients, transvaginal ultrasound (TVS) attention to rule out the occupancy of the uterine cavity, such as the discovery of intrauterine occupancy, hysteroscopy required. Conversely, for patients with endometrial polyps that are TVS or hysteroscopic tips, laparoscopic indications may be relaxed to determine if EMs are present.