目的 探究肠道子宫内膜异位症（简称肠道内异症）患者术前肠道症状的的临床特征，比较病灶削除与肠段切除对术后肠道功能的影响。 方法 前瞻性纳入2013年8月1日至2017年12月30日期间于复旦大学附属妇产科医院经由同一手术组医生诊治且术后病理诊断为肠道内异症的患者（n=105）。通过门诊及电话随访，收集其术前T0及术后3个时间节点（T1：2018年11月；T2：2020年11月；T3：2024年4月）的临床数据。主要结局指标为肠道症状和肠道功能评分，次要结局指标为疼痛症状评分，采用广义估计方程（generalized estimating equations，GEE）模型分析术式与随访时间对结局指标的交互效应。 结果 最终纳入89例患者（失访率为15.24%），其中病灶削除术79例（88.76%）。术前46例（51.68%）有肠道症状，以经期肛门坠胀感（21例，46.65%）和腹泻（15例，32.61%）为主；术后便秘比例显著升高，（T1：71.43%；T2：50.00%；T3：72.00%）。两组术后痛经、胃肠道不适评分及胃肠道生活质量指数等均显著改善（P均<0.000 5），但肠段切除组术后直肠前切除综合征评分以及便秘评分显著高于病灶削除组（P=0.02和P=0.05）。 结论 术前约半数肠道内异症患者存在典型肠道症状（如肛门坠胀、腹泻）。病灶削除术与肠段切除术均能有效缓解疼痛，但病灶削除术在保留肠道功能方面更具优势，而肠段切除术可能因肠道结构改变导致术后便秘或排便模式紊乱风险增加。术式选择需权衡病灶清除彻底性与术后功能保护，建议术前充分告知患者风险。

Objective To investigate the clinical characteristics of preoperative intestinal symptoms in patients with bowel endometriosis and to compare the effects of shaving versus segmental bowel resection on postoperative intestinal function. Methods A total of 105 patients diagnosed with bowel endometriosis and treated by the same surgical team at the Obstetrics and Gynecology Hospital， Fudan University between Aug 1， 2013 and Dec 30， 2017 were prospectively enrolled in this study. Clinical data were collected via outpatient visits and telephone follow-ups at four time points： preoperative （T0） and postoperative （T1： Nov 2018； T2： Nov 2020； T3： Apr 2024）. The primary outcome was bowel symptoms and gastrointestinal function scores； secondary outcome was pain scores. A generalized estimating equation （GEE） model was used to analyze the interaction effect of surgical approach and follow-up time on outcomes. Results Ultimately， a total of 89 patients were included （15.24% loss to follow-up）， among whom 79 patients （88.76%） underwent shaving excision. Preoperatively， 46 patients （51.68%） presented with bowel symptoms， primarily anus bulge （21 cases， 46.65%） and diarrhea （15 cases， 32.61%） during menstruation. Postoperatively， there was a significant increase in constipation rates （T1：71.43%；T2：50.00%；T3：72.00%）. Both surgical groups exhibited significant improvements in dysmenorrhea， gastrointestinal discomfort scores as well as gastrointestinal quality of life index （P<0.000 5）. However， the segmental resection group had significantly higher scores for low anterior resection syndrome， constipation compared with the shaving excision group（P=0.02 and P=0.05）. Conclusion Approximately half of the patients with bowel endometriosis exhibit typical bowel symptoms preoperatively， such as anus bulge and diarrhea. Both shaving excision and segmental resection effectively alleviate pain； however， shaving excision demonstrates an advantage regarding preservation of bowel function， whereas segmental resection may elevate risks associated with postoperative constipation or altered defecation patterns due to structural changes. The selection of surgical approach should carefully balance lesion removal and functional preservation， moreover， be sure that potential risks are thoroughly informed to patients prior to surgery.