成人型囊性子宫腺肌病11例临床分析  

Clinical analysis of 11 cases of adult cystic adenomyosis

作　　者：李婵婵 范艳艳[1] 付艳[1] LI Chan-chart;FAN Yan -yan;FU Yan(Department of Gynecology,The First Bethune Hospital of Jilin University,Jilin Changchun 130021,P.R.China)

机构地区：[1]吉林大学第一医院妇科,吉林长春130021

出　　处：《中国计划生育和妇产科》2018年第12期69-72,共4页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的探讨成人型囊性子宫腺肌病的临床特点、诊断及治疗,为临床诊疗提供参考依据。方法回顾性分析吉林大学第一医院2011年1月至2017年5月收治的手术病理诊断为囊性子宫腺肌病的11例患者的临床资料。结果 11例患者主要的临床症状为痛经进行性加重5例(45.45%),其次为经量增多及经期延长2例(18.18%),其余症状为间断下腹痛、绝经后不规则阴道流血、发现血色白带以及无明显临床症状仅体检发现子宫肿物各1例(各9.09%);合并继发性贫血7例;合并不孕症2例。11例患者术前均行妇科彩超检查,检查见子宫肌壁间低回声光团8例(72.73%),平均51 mm×39 mm。于低回声光团内可见不整形液性暗区(62.50%,5/8),平均28 mm×17 mm。宫腔内混杂偏低回声光团3例(27.27%),平均42 mm×30 mm。其内也可见不整形液性暗区(66.67%,2/3),平均17 mm×8 mm。11例患者均行手术治疗,其中经腹手术8例,宫腔镜手术3例。术后接受随访的8例患者临床症状均消失,4例贫血患者亦纠正贫血状态,术后无1例复发。结论囊性子宫腺肌病的临床表现缺乏特异性,超声检查及盆腔核磁共振检查对协助明确诊断有重要意义。囊性子宫腺肌病在临床少见,容易误诊、漏诊。尽早手术治疗及术后辅以药物治疗可以明显缓解痛经、月经过多、贫血等症状。Objective To explore the clinical features,diagnosis and treatment of adult cystic adenomyosis,and to provide reference for clinicians to diagnose and treat the disease.Methods The clinical data of 11 patients with cystic adenomyosis diagnosed by surgery in The First Bethune Hospital of Jilin University from January 2011 to May 2017 were retrospectively analyzed.Results The clinical symptoms of most of the 11 patients were aggravated progressive dysmenorrhea(45.45 %,5/11),followed by increased menstrual flow and prolonged menstruation(18.18 %,2/11).The other symptoms were intermittent abdominal pain(9.09 %,1/11)and irregular vaginal bleeding after menopause(9.09 %,1/11),the blood color leucorrhea(9.09 %,1/11) and no obvious clinical symptoms were found only in the examination of the uterus tumor(9.09 %,1/11).7 cases with secondary anemia,2 cases of infertility,11 patients underwent gynecological examination before surgery,and the low-echo light group(72.73 %,8/11) of the uterine muscle wall was examined,with an average size of 51 mm × 39 mm.In the low-echo light group,the non-plastic liquid dark area(62.50 %,5/8) is visible,with an average size of 28 mm × 17 mm.Low-echo light group(27.27 %,3/11) in uterine cavity,with an average size of 42 mm × 30 mm.It can also be seen in the non-plastic liquid dark area(66.67 %,2/3),with an average size of 17 mm × 8 mm.All 11 patients underwent surgical treatment,8 patients underwent abdominal surgery,3 patients underwent hysteroscopic surgery.The clinical symptoms of 8 patients with postoperative follow-up were all gone,4 cases with secondary anemia were corrected and no recurrence was observed after surgery.Conclusion The clinical manifestations of cystic adenomyosis are lack of specificity.Ultrasonic examination and magnetic resonance pelvic scanning were important to help clarify the diagnosis.Cystic adenomyosis is rare in clinical practice and is easily misdiagnosed.Early operation and adjuvant therapy can obviously alleviate the symptoms such as excessive menstrual an

关 键 词：成人型囊性子宫腺肌病 子宫腺肌症 诊断 治疗 

分 类 号：R711.7[医药卫生—妇产科学]