宫颈子宫内膜异位症伴活动性阴道出血一例并文献复习  

Acute Vaginal Bleeding Caused by Cervical Endometriosis: A Case Report and Literature Review

作　　者：许阡 段华[1] 金佟 臧春逸[1] XU Qian;DUAN Hua;JIN Tong;ZANG Chun-yi(Gynecologic Minimally Invasive Center,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100006,China)

机构地区：[1]首都医科大学附属北京妇产医院妇科微创中心

出　　处：《国际妇产科学杂志》2019年第5期549-551,I0001,共4页Journal of International Obstetrics and Gynecology

基　　金：国家自然科学基金(81571412)

摘　　要：宫颈子宫内膜异位症为特殊类型子宫内膜异位症,其伴活动性阴道出血症状,国内外多为个案报道。本文介绍了1例急诊就诊患者,月经干净后第2日出现活动性阴道出血。患者孕3产0,阴道出血量为月经量4~5倍,超声提示宫颈处膨大,给予催产素治疗后血止。住院行双侧子宫动脉栓塞后,行宫腔镜检查提示宫颈管8点处憩室样囊腔,内含大量陈旧血迹,遂行宫腔镜切除、电凝囊腔,术后病理提示宫颈子宫内膜异位囊肿。2年后复查宫腔镜,提示原宫颈病灶囊腔处可见缺损,囊壁可见瘢痕修复,术后随访至今无复发。文献复习宫颈子宫内膜异位囊肿发病机制、临床表现、诊断、治疗,并最后总结该病例经验教训。Cervical endometriosis is a special type of endometriosis associated with active vaginal bleeding, which has been reported in many cases at home and abroad. In this case, a 40-year-old nulliparous woman, G3P0, visited to emergency room with massive vaginal hemorrhage on the second day after menstruation. The volume of vaginal hemorrhage is 4 to 5 times of normal menstruation. Ultrasound revealed dilatation of the cervix. The bleeding stopped after treatment with oxytocin. After bilateral uterine artery embolization in hospital, the hysteroscopy revealed a large amount of old blood in the diverticulum-like cystic space at 8 o′clock in the cervical canal. Then, hysterscopic resection and electrocoagulation of the cystic space were performed. Postoperative pathology revealed a cervical endometriosis cyst. The second hysteroscopy was performed in 2 years later and showed a defect the cavity of the original cervical lesion and scar repair in the wall of the cyst. There was no recurrence in the follow-up so far. This article reviews the literature on the pathogenesis, clinical presentation, diagnosis, and treatment of endometriosis cyst of the cervix, and concludes with lessons learned from this case.

关 键 词：宫颈疾病 子宫内膜异位症 出血 病例报告 

分 类 号：R711.71[医药卫生—妇产科学]