在阴道,肠道或膀内有子宫内膜异位症的患者经历了长时间的诊断延迟:一项观察性研究
M E Madsen1,2,3,4, D Hartwell1, L K A Kähler1
1Department of Gynaecology, The Endometriosis Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen Ø, Denmark.
Human reproduction (Oxford, England)
|March 24, 2025
概括
先进的子宫内膜异位症,涉及关键器官,与显著更长的诊断延迟和更早的症状发作有关. 早期诊断对于预防子宫内膜异位症患者严重并发症和器官损伤至关重要.
科学领域:
- 妇科 妇科 妇科 妇科
- 手术病理学手术病理学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 子宫内膜异位症患者经常面临长期的诊断延迟,延迟时间和疾病严重程度之间的关联尚不清楚.
- 了解这种联系对于及时治疗至关重要,有可能防止不可逆转的器官损伤和复杂的手术.
- 晚期子宫内膜异位症涉及阴道,肠道,直阴间隔膜或膀 (eVIRB) 等关键结构.
研究的目的:
- 为了调查是否诊断延迟和症状在先进 (eVIRB) 和非先进疾病的子宫内膜异位症患者之间有所不同.
- 确定诊断延迟的持续时间和晚期子宫内膜异位症的存在之间的关系.
主要方法:
- 一项观察性队列研究,涉及129名在三年内接受子宫内膜异位症手术的患者.
- 收集了关于症状和诊断延迟的回顾性问卷数据,并与手术内外科发现相关联.
- 患者在丹麦的三级子宫内膜异位症中心接受了中度至重度子宫内膜异位症的治疗.
主要成果:
- 诊断延迟的中位数为5年;然而,eVIRB患者 (n=75) 的中位数延迟显著更长,为9年,而非eVIRB患者的中位数延迟为2年 (n=54).
- 超过5年的诊断延迟使得患有eVIRB的几率增加了五倍.
- eVIRB患者报告说,症状较早出现,经历了更严重的月经,需要缓解疼痛和休息.
结论:
- 这项研究确定了长时间的诊断延迟和晚期子宫内膜异位症之间的关联,独立于激素治疗的持续时间和手术时的年龄.
- 这些发现强调了急需制定战略,以加快晚期子宫内膜异位症患者的诊断,以减轻严重并发症.
- 局限性包括追溯数据收集中的潜在回忆偏差;研究确定关联,而不是因果关系.
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