摘要： 目的 探讨子宫内膜典型性腺肌瘤性息肉的临床特征、诊治方法及预后。方法 回顾性分析中国医科大学附属盛京医院2012年1月至2017年12月病理确诊为子宫内膜典型性腺肌瘤性息肉的450例患者的临床病理资料和治疗方案，并对保留子宫的患者进行随访。结果 患者平均发病年龄为52.2岁，>40~60岁年龄段发病者占58.2%；绝经前与绝经后患者中，表现为异常阴道流血者分别占58.8%及32.5%。阴道超声的诊断准确率为38.7%，宫腔镜为70.8%，两者误诊肌瘤率分别为11.5%和27.5%，差异均有统计学意义；超声误诊恶性率1.11%，磁共振误诊恶性率14.46%，宫腔镜无误诊恶性者；249例取得随访资料的患者中，复发12例，均为绝经前患者。结论 子宫内膜典型性腺肌瘤性息肉好发于围绝经期女性；异常阴道流血为主要临床表现；宫腔镜诊断准确率高于盆腔超声及磁共振，且可降低术前误诊恶性率，但更易与子宫黏膜下肌瘤相混淆；宫腔镜下息肉电切术安全有效，复发率低。

子宫内膜典型性腺肌瘤性息肉450例临床分析

王蛟, 杨清

中国医科大学附属盛京医院妇产科, 沈阳 110004

收稿日期:2020-04-13出版日期:2021-02-28发布日期:2021-01-21
通讯作者:杨清E-mail:yangqing_sj@126.com
作者简介:王蛟(1988-),女,主治医师,硕士.
基金资助:国家自然科学基金（81872125）；盛京自由研究者基金（201704）


关键词: 腺肌瘤性息肉, 子宫, 超声, 宫腔镜
Abstract: Objective To investigate the clinical features,diagnostic and treatment modalities,and prognosis of endometrial adenomyomatous polyps (EAPs). Methods We performed a retrospective analysis on 450 cases with EAPs from January 2012 to December 2017 in Shengjing Hospital of China Medical University. Results The average age was 52.2 years;patients aged 41 to 60 years accounted for 58.2% of the sample. Premenopausal and postmenopausal patients with abnormal vaginal bleeding accounted for 58.8% and 32.5% of the study sample,respectively. The diagnostic accuracy of transvaginal ultrasound was 38.7%;for hysteroscopy,it was 70.8%. The misdiagnosis rates of transvaginal ultrasound and hysteroscopy for submucosal myoma were 11.5% and 27.5%,respectively,and the finding was statistically significant. The misdiagnosis rates for endometrial cancer using ultrasound,hysteroscopy,and MR were 1.11%,0%,and 14.46%,respectively. Out of 249 patients,12 had relapses,and all of these were premenopausal women. Conclusion EAP was more likely to occur in perimenopausal women. Abnormal vaginal bleeding was the main clinical manifestation. The diagnostic accuracy of hysteroscopy was higher than that of ultrasound and MR. The misdiagnosis rate of endometrial cancer using hysteroscopy was the lowest,although it was more easily confused with submucosal myoma. Hysteroscopic resection is safe and effective,with a low recurrence rate.
Key words: adenomyomatous polyps, uterus, ultrasound, hysteroscopy
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