CAJ | 학술논문

目的：探讨子宫内膜异位症痛经患者诊断延迟的原因。方法制订《痛经及慢性盆腔痛调查表》，对2012年1月～2014年2月336例门诊就诊的痛经患者进行回顾性调查，分析子宫内膜异位症患者的诊断延迟情况。结果205例诊断为子宫内膜异位症，诊断延迟时间为10年（0～31年），初潮即痛经者，诊断延迟时间为15年（5～31年），明显大于初潮后痛经者（15年 vs．6年，Z ＝－7．547，P ＝0．000）。痛经逐渐加重的患者，诊断延迟时间小于无加重者（9年 vs．11年）；合并伴随症状者，诊断延迟时间小于无伴随症状者（8年 vs．10年）；合并子宫腺肌症的患者，诊断延迟时间小于未合并者（8年 vs．10年），但以上差异均无统计学意义（P ＞0．05）。结论子宫内膜异位症存在诊断延迟，初潮即痛经者，其诊断延迟的时间更长。痛经症状持续加重、合并伴随症状、合并子宫腺肌症，更有利于相对早期的诊断。
목적：탐토자궁내막이위증통경환자진단연지적원인。방법제정《통경급만성분강통조사표》，대2012년1월～2014년2월336례문진취진적통경환자진행회고성조사，분석자궁내막이위증환자적진단연지정황。결과205례진단위자궁내막이위증，진단연지시간위10년（0～31년），초조즉통경자，진단연지시간위15년（5～31년），명현대우초조후통경자（15년 vs．6년，Z ＝－7．547，P ＝0．000）。통경축점가중적환자，진단연지시간소우무가중자（9년 vs．11년）；합병반수증상자，진단연지시간소우무반수증상자（8년 vs．10년）；합병자궁선기증적환자，진단연지시간소우미합병자（8년 vs．10년），단이상차이균무통계학의의（P ＞0．05）。결론자궁내막이위증존재진단연지，초조즉통경자，기진단연지적시간경장。통경증상지속가중、합병반수증상、합병자궁선기증，경유리우상대조기적진단。
Objective To explore the causes of diagnostic delay of endometriosis. Methods We designed a dysmenorrhea and chronic pelvic pain questionnaire.Patients with dysmenorrhea who consulted in gynecological outpatient of the Peking University Third Hospital from January 2012 to February 2014 were asked to fill the questionnaire. Details of their dysmenorrhea were retrospectively analyzed,and the diagnostic delay of endometriosis were analyzed. Results A total of 205 patients were diagnosed as having endometriosis but had a median diagnostic delay of 10 years (0 -31 years).Of the 205 cases,those suffering dysmenorrhea at menarche had a median of 15 years of diagnostic delay,longer than those who suffered dysmenorrhea after menarche (15 years vs.6 years,Z =7.547,P =0.000).Patients with aggravating dysmenorrhea showed shorter diagnostic delay time than others (9 years vs. 1 1 year),and patients accompanying symptoms showed shorter diagnostic delay time than others (8 years vs.10 years),and patients with adenomyosis also showed shorter diagnostic delay time than others (8 years vs.10 years),but all of them had no statistically significant differences(P >0.05 ). Conclusions There is delay in the diagnosis of endometriosis.Patients with dysmenorrhea at menarche showed longer delay. Aggravating dysmenorrhea, accompanying symptoms and adenomyosis may relatively help early diagnosis.