论文部分内容阅读
作者报告了２６例直肠子宫内膜异位症的诊断和手术治疗的经验。该病在临床症状、体征等方面易与直肠癌相混淆，易引起误诊和误治，但在病史上有其特点，即直肠刺激征、胀痛或便血，常在月经前后加重。便血在月经期多见。直肠指检和妇科检查，直肠触及的肿块多位于粘膜下，与阴道壁和宫颈粘连。直肠镜检查直肠粘膜病变较轻，仅为充血糜烂或息肉状隆起。组织病理学检查为慢性炎症表现。手术适应证为保守治疗无效、症状明显、影响正常生活者；病灶小者行局部肠壁楔形切除，病灶大而深，位置低者可以行前切除吻合术。本组局部切除１６例，前切除吻合术１０例。术后症状消失者２１例，症状改善者５例。２例５年后症状复发，行再次手术后恢复。
The authors report 26 cases of rectal endometriosis diagnosis and surgical treatment experience. The disease in clinical symptoms, signs and other aspects easily confused with rectal cancer, easily lead to misdiagnosis and misdiagnosis, but in the history has its own characteristics, namely, rectal irritation, pain or blood in the stool, often before and after menstruation increased. Blood in the stool is more common in menstruation. Rectal examination and gynecological examination, rectal palpable mass in the submucosal and vaginal wall and cervical adhesions. Rectal examination of rectal mucosal lesion is mild, only congestive erosion or polypoid bulge. Histopathology is a manifestation of chronic inflammation. Surgical indications for conservative treatment ineffective, obvious symptoms, affecting normal life; lesser lesion local wedge resection of the bowel wall, the lesion is large and deep, the location of the lower anterior resection and anastomosis. The group of partial resection in 16 cases, anterior resection and anastomosis in 10 cases. 21 cases of postoperative symptoms disappeared, symptoms improved in 5 cases. 2 cases 5 years after the recurrence of symptoms, the line after the resumption of surgery.