本文選題：深部浸潤型子宮內(nèi)膜異位癥 + 神經(jīng)纖維�。� 參考：《中國實(shí)用婦科與產(chǎn)科雜志》2016年09期

【摘要】：目的探討深部浸潤型子宮內(nèi)膜異位癥(DIE)宮骶韌帶病灶及陰道直腸隔病灶中神經(jīng)纖維束狀浸潤(NFBI)情況及其與患者疼痛的相關(guān)性。方法收集2012-06-01—2015-01-01在中山大學(xué)附屬第一醫(yī)院婦科行手術(shù)治療的64例DIE患者,采用免疫組化的方法分別檢測宮骶韌帶病灶和陰道直腸隔病灶中神經(jīng)纖維蛋白基因產(chǎn)物9.5(PGP9.5)和GAP-43染色陽性的神經(jīng)纖維。根據(jù)是否存在神經(jīng)纖維束狀浸潤分為兩組:NFBI陽性組和NFBI陰性組。比較兩組患者痛經(jīng)、肛門墜脹痛、性交痛和慢性盆腔痛程度,并探討二者之間新生神經(jīng)纖維密度的差異。結(jié)果宮骶韌帶DIE病灶中NFBI陽性組痛經(jīng)、肛門墜脹痛和慢性盆腔痛評分均比NFBI陰性組高,差異有統(tǒng)計(jì)學(xué)意義(均P0.05);性交痛評分兩組差異無統(tǒng)計(jì)學(xué)意義(P=0.12)。陰道直腸隔DIE病灶中NFBI陽性組痛經(jīng)、肛門墜脹痛、性交痛和慢性盆腔痛評分均比NFBI陰性組高,差異均有統(tǒng)計(jì)學(xué)意義(均P0.05)。宮骶韌帶DIE病灶和陰道直腸隔DIE病灶中NFBI陽性患者的新生神經(jīng)纖維(GAP-43染色陽性的神經(jīng))密度均比NFBI陰性患者高,差異均有統(tǒng)計(jì)學(xué)意義(P=0.001,P=0.007)。結(jié)論深部浸潤型子宮內(nèi)膜異位癥病灶中神經(jīng)纖維束狀浸潤與患者疼痛的嚴(yán)重程度相關(guān),其原因之一可能是刺激新生神經(jīng)纖維生長增加。
[Abstract]:Objective to investigate the neurofiber bundle infiltration (NFBI) in the sacral ligament lesions and the vagina rectum lesions in deep invasive endometriosis (DIEs) and its correlation with pain. Methods Sixty-four patients with DIE who underwent gynecological surgery in the first affiliated Hospital of Sun Yat-sen University in 2012-06-01-2015-01-01 were collected. Immunohistochemical method was used to detect neurofibrin gene product 9.5 PGP 9.5) and GAP-43 positive nerve fibers in the lesions of the uterine sacral ligament and the septum of vagina and rectum respectively. According to the presence of nerve fiber bundle infiltration, divided into two groups: NFBI positive group and NFBI negative group. The degree of dysmenorrhea, anus distention pain, sexual intercourse pain and chronic pelvic pain were compared between the two groups, and the difference of the density of neonate nerve fibers between the two groups was discussed. Results the scores of dysmenorrhea, anal distention and chronic pelvic pain in NFBI positive group were significantly higher than those in NFBI negative group (P 0.05), but there was no significant difference in sexual intercourse pain score between the two groups. The scores of dysmenorrhea, anal distention pain, coital pain and chronic pelvic pain in patients with positive NFBI were significantly higher than those in patients with negative NFBI (all P 0.05). The density of neonate nerve fibers with positive expression of GAP-43 in the lesions of the uterine sacral ligament and the septum of the vagina and rectum was higher than that in the patients with negative NFBI, and the difference was statistically significant. Conclusion the nerve fiber bundle infiltration in deep invasive endometriosis is related to the severity of pain, and one of the reasons may be to stimulate the growth of new nerve fibers.
【作者單位】： 中山大學(xué)附屬第一醫(yī)院婦產(chǎn)科;中山大學(xué)中山醫(yī)學(xué)院;
【基金】：中山大學(xué)2015年第二批學(xué)生業(yè)余科研項(xiàng)目(59) 廣州市科技計(jì)劃項(xiàng)目(201300000169) 廣東省科技計(jì)劃項(xiàng)目(2013B021800237)
【分類號】：R711.71

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