小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 痛经
- 慢性或周期性盆腔痛
- 性交疼痛
- 低生育力
- 宫骶韧带结节形成
- 盆腔肿块
- 子宫后倾、固定
- 抑郁症
- 焦虑
- 因痛经而无法上班或上学
其他诊断因素
- 排尿困难、腰痛和血尿
- 大便困难、便血
危险因素
- 育龄期人群
- 白种人
- 阳性家族史
- 未育
- 体重指数 (BMI) 较低
- 苗勒管畸形
- 自身免疫性疾病
- 初次性生活年龄较晚
- 吸烟
- 既往剖宫产
诊断性检查
首要检查
- 经阴道超声
需考虑的检查
- 直肠超声内镜
- 3D 超声
- 子宫输卵管造影
- 骨盆核磁共振 (MRI)
- 诊断性腹腔镜检查
治疗流程
无立即生育意愿：无巧克力囊肿或可疑重度/深部子宫内膜异位症的疼痛患者
无立即生育意愿：有巧克力囊肿或可疑重度/深部子宫内膜异位症的疼痛患者
有立即生育意愿
撰稿人
作者
M. Jonathon Solnik, MD, FACOG FACS
Professor of Obstetrics, Gynaecology and Medical Imaging by Cross-Appointment
Temerty School of Medicine at the University of Toronto
Head of Gynaecology & Minimally Invasive Surgery
Sinai Health System & Women's College Hospital
Toronto
Canada
利益声明
MJS is an author of a number of references cited in this topic. He acts as a consultant for AbbVie (manufacturer of depot leuprolide and elagolix), Medtronic, Felix Health and Olympus.
Ari Sanders, MD, FRSCS
Clinical Assistant Professor of Obstetrics and Gynecology
Division of Minimally Invasive Gynecologic Surgery
Department of Obstetrics and Gynecology
Peter Lougheed Centre
University of Calgary
Calgary
Canada
利益声明
AS acts as a speaker for Abbvie, Hologic, and Bayer. He is an author of one of the articles cited in this topic.
鸣谢
Dr M. Jonathon Solnik and Dr Ari Sanders would like to gratefully acknowledge Dr Sharon M. Jakus, a previous contributor to this topic.
利益声明
SMJ declares that she has no competing interests.
同行评议者
Joseph S. Sanfilippo, MD, MBA
Professor
Department of Obstetrics, Gynecology, and Reproductive Sciences
Vice Chairman
Reproductive Sciences
Director
Division of Reproductive Endocrinology and Infertility
University of Pittsburgh
Pittsburgh
PA
利益声明
JSS declares that he has no competing interests.
Justin C. Konje, MBBS, FMCOG, MRCOG, FWACS, MD, MBA
Professor of Obstetrics and Gynaecology
Leicester Royal Infirmary
Leicester
UK
利益声明
JCK declares that he has no competing interests.
鉴别诊断
- 子宫腺肌病
- 间质性膀胱炎
- 盆腔炎性疾病 (pelvic inflammatory disease, PID)
更多 鉴别诊断指南
- 欧洲人类生殖与胚胎学会子宫内膜异位症指南
- 子宫内膜异位症临床实践指南
更多 指南患者教育信息
何为子宫内膜异位症？
子宫内膜消融术（透热疗法）
更多 患者教育信息
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