宋瑞彬　董山峰　崔志刚

[摘要] 输尿管子宫内膜异位症是一种少见疾病，其发病隐匿，临床无特异性症状，早期诊断困难，常导致肾功能损害。腰腹部疼痛是其常见的临床症状，影像学对于疾病的诊断有重要作用，确诊需要病理学检查。手术是治疗该病的有效手段，手术方式需要据病变的位置、范围及深度确定。我院从2013年1月～2014年11月收治2例输尿管子宫内膜异位症患者，2例均行手术治疗，1例给予输尿管病部分切除术和输尿管膀胱再植术，1例给予输尿管部分切除术和输尿管端端吻合术。术后2例患者临床症状消失，肾积水减轻，随访1～2年，输尿管子宫内膜异位症均未复发，手术治疗效果满意。

[关键词] 子宫内膜异位症；输尿管；外科手术；肾积水；输尿管梗阻

[中图分类号] R693 [文献标识码] A [文章编号] 1674-4721（2016）02（c）-0040-03

[Abstract] Ureteral endometriosis is a rare disease in a hidden onset and without specific symptoms in clinic.It is difficult to make a diagnosis at an early stage，and usually leads to renal function damage.Waist and abdominal pain is a common clinical symptom.Imageology plays an important role in disease diagnosis.Definite diagnosis is through pathological examination.Surgery is an effective way to treat the disease.The operative method is depended on pathological location，range，and depth.From January 2013 to November 2014，2 patients with ureteral endometriosis were admitted into our hospital.They were both performed with surgeries.One patient was provided with partial excision of ureter and ureteral-bladder reimplantation，and the other case was treated by partial excision of ureter and ureteroureterostomy.After surgery，the clinical symptoms in both patients were gone，and hydronephrosis was alleviated.During one to two years follow up visits，ureteral endometriosis was no recurred.The surgical effect was satisfactory.

[Key words] Endometriosis；Ureter；Surgical operation；Hydronephrosis；Ureteral obstruction

输尿管子宫内膜异位症是临床一种少见的疾病，常表现为输尿管组织中出现子宫内膜组织。异位的子宫内膜在输尿管中种植浸润生长，致使输尿管受压，变得狭窄、迂曲、梗阻，导致肾积水及肾功能损害，继发感染，出现腰痛、血尿、发热等临床症状，易误诊为输尿管肿瘤。手术是较为有效的治疗方法。我院自2013年1月～2014年11月收治2例输尿管子宫内膜异位症患者，给予手术治疗，术后随访1～2年，效果满意，现报道如下。

1 资料与方法

例1，患者，43岁，于2013年1月9日因右侧腰部间断钝痛半年入院，无尿急、尿痛、尿频，无肉眼血尿，无发热。患者既往因子宫肌瘤行子宫切除术1年余。查体：体温正常，右肾区轻度叩击痛。……