绝经后子宫内膜结核临床诊断的探讨  

Preliminary Study of the Clinical Diagnosis on Postmenopausal Endometrial Tuberculosis

作　　者：陆学媚[1] 彭艳丽[1] 高静儒 李娜[1] 黄培[1] 尹聪[1] 

机构地区：[1]北京市普仁医院妇科,北京100062

出　　处：《中国医药导刊》2015年第7期661-662,共2页Chinese Journal of Medicinal Guide

摘　　要：目的：探讨绝经后子宫内膜结核（PET）的临床诊断特点。方法：回顾性分析4例PET患者的临床资料并进行文献复习。结果：4例患者初诊子宫内膜癌3例（3/4）,子宫内膜炎1例（1/4）;既往有结核病史2例（2/4）;临床表现：阴道流液3例（3/4）,腹痛2例（2/4）,阴道顶端广泛粘连2例（2/4）,宫腔积液4例（4/4）;4例均行宫腔镜检查及诊刮术,病理结果：上皮细胞肉芽肿1例（1/4）,干酪样坏死3例（3/4）;4例患者均行标准短程抗结核治疗,随访1～6年未见复发。结论：子宫内膜不规则增厚、彩色多普勒血流显像无或少量血流信号及宫腔积液为PET超声三联征,可首选盆腔彩色多普勒超声检查,注意患者结核病史。Objective： To investigate the clinical diagnosis of postmenopausal endometrial tuberculosis（PET）. Methods： To review the clinical data of 4 patients with PET and review the literatures. Results： 4 cases of patients with newly diagnosed endometrial carcinoma in 3 cases（3/4）, endometritis in 1 case（1/4）; previous history of tuberculosis in 2 cases（2/4）; clinical manifestations： vaginal discharge in 3 cases（3/4）, abdominal pain in 2 cases（2/4）, top of the vagina extensive adhesion in 2 cases（2/4）, uterine cavity effusion in 4 cases（4/4）; 4 cases underwent hysteroscopy and diagnostic curettage, pathological results： epithelioid cell granuloma in 1 case（1/4）, caseous necrosis in 3 cases（3/4）; 4 patients underwent standard short-range anti tuberculosis treatment and followed up for 1～6 years showed no recurrence. Conclusions： The endometrial irregular thickening, color Doppler blood flow imaging no or a small amount of blood flow signals and uterine fluid are PET ultrasound triad, can choose the pelvic ultrasound examination, attention to the history of tuberculosis.

关 键 词：绝经后 子宫内膜结核 阴道流液 腹痛 阴道粘连 宫腔积液 

分 类 号：R527[医药卫生—内科学]