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目的:总结23例输尿管子宫内膜异位症患者的临床诊断和治疗经验。方法:回顾性分析23例病理证实为输尿管子宫内膜异位症患者的临床诊治以及术后随访资料,并对结果进行对比分析。结果:23例患者均接受了超声检查,其中21例接受了静脉肾盂造影检查,11例接受了逆行肾盂造影检查,16例接受了CT检查,8例接受了MRI检查;23例均行手术治疗,其中3例接受了输尿管粘连松解术治疗,6例接受了输尿管狭窄段切除+输尿管膀胱再吻合术治疗,12例接受了输尿管狭窄段切除+输尿管端端吻合术治疗,2例接受了输尿管内镜下子宫内膜异位病损电灼术治疗。23例患者均为单侧发病,左侧14例,右侧9例。术后病理检查证实为子宫内膜异位症,异位病灶均位于输尿管下段。结论:输尿管子宫内膜异位症是一种泌尿外科罕见的疾病,早期诊断难度较大,影像学检查在输尿管子宫内膜异位症的诊断中起着重要作用。对于轻度的输尿管梗阻患者,推荐行输尿管粘连松解术治疗;对于中、重度输尿管梗阻患者,推荐行输尿管狭窄段切除术治疗;对于病变程度严重的病例,推荐术后应用激素类药物治疗降低术后的复发率。
Objective: To summarize the clinical diagnosis and treatment experience of 23 patients with ureteral endometriosis. Methods: A retrospective analysis of 23 cases of pathologically confirmed patients with ureteral endometriosis clinical diagnosis and treatment and postoperative follow-up data, and the results were compared. RESULTS: Twenty-three patients underwent ultrasound, of which 21 received intravenous pyelography, 11 received retrograde pyelography, 16 received CT, and 8 received MRI. Twenty-three patients underwent surgery , Of which 3 received ureteral adhesion lysis, 6 received ureteral stricture resection plus ureterovenerectomy, 12 received ureteral stricture resection plus ureteral end-to-end anastomosis, and 2 received ureter Endoscopic endometriosis lesions electrosurgery treatment. All 23 patients were unilateral, with 14 on the left and 9 on the right. Postoperative pathology confirmed endometriosis, ectopic lesions are located in the lower ureter. Conclusion: Ureteral endometriosis is a rare disease in urology. Early diagnosis is very difficult. Imaging examination plays an important role in the diagnosis of ureteral endometriosis. For patients with mild ureteral obstruction, ureteral adhesion lysis is recommended; for patients with moderate or severe ureteral obstruction, ureteral stricture resection is recommended; for patients with severe degree of disease, postoperative hormone therapy is recommended Postoperative recurrence rate.