宫颈子宫内膜异位症84例临床病例分析  

Clinical Analysis of 84 Cases of Cervical Endometriosis

作　　者：许阡 段华[1] 汪沙[1] 安圆圆 XU Qian;DUAN Hua;WANG Sha;AN Yuan-yuan(Gynecology Minimally Invasive Center,Beijing Obstetrics and Gynecology Hospital,Capital Medical University/Beijing Maternal and Child Health Care Hospital,Beijing 100006,China)

机构地区：[1]首都医科大学附属北京妇产医院/北京妇幼保健院妇科微创中心,100006

出　　处：《国际妇产科学杂志》2024年第3期302-305,311,共5页Journal of International Obstetrics and Gynecology

摘　　要：目的:探讨宫颈子宫内膜异位症的临床特点、治疗和预后。方法:回顾2009年1月—2021年1月首都医科大学附属北京妇产医院收治的经组织病理学确诊为宫颈子宫内膜异位症的84例患者的临床资料,分析其临床表现、辅助检查、术中所见、病理特点及预后。结果:①84例患者中,临床无相关症状患者73例(86.9%),有痛经、接触性出血和间断高热患者各1例(1.2%),不规则子宫出血患者8例(9.5%),其中6例患者为阴道间断或持续少量出血,1例患者为绝经后少量阴道出血,1例患者为阴道大量出血;②术前盆腔超声检查提示宫颈异常回声19例(22.6%),11例行磁共振成像检查的患者中仅3例提示宫颈出血性囊性占位;③术中肉眼可见14例宫颈局部紫蓝色病灶和12例宫颈囊肿,58例肉眼未见明显子宫内膜异位病灶,患者术后病理均提示宫颈子宫内膜异位病灶,17例患者合并妇科恶性肿瘤,17例患者合并宫颈上皮内瘤变。84例患者随访时间36~180个月,均未见复发。结论:宫颈子宫内膜异位症发病隐匿,多数无临床症状,可出现感染、大量阴道出血等症状,因其可恶变或与妇科恶性疾病共存,需引起临床关注。Objective:To investigate the clinical features,treatment and prognosis of cervical endometriosis.Methods:The clinical data of 84 cases diagnosed with cervical endometriosis by histopathology from January 2009 to January 2021 in the Beijing Obstetrics and Gynecology Hospital of Capital Medical University were analyzed retrospectively,analyzing their clinical characteristics,imaging,intraoperative performance,pathological features and prognosis.Results:①Among 84 patients,73(86.9%)were clinically asymptomatic,1(1.2%)had dysmenorrhoea,1(1.2%)had contact bleeding and 1(1.2%)had intermittent hyperthermia,and 8(9.5%)had irregular uterine bleeding,of which 6 patients had intermittent or continuous few episodes of vaginal bleeding,1 patient had postmenopausal vaginal bleeding,and one patient had massive vaginal bleeding.②Preoperative pelvic ultrasound examination revealed cervical abnormal echoes in 19 cases(22.6%),and cervical haemorrhagic cystic lesions was found in only 3 of the 11 patients who underwent MRI.③Localized purple-blue lesions in the cervix were seen in 14 cases,cervical cysts were seen in 12 cases and no obvious endometriosis lesions were seen in 58 cases,all patients were diagnosed with endometriotic lesions of the cervix on postoperative pathology.17 patients were complicated with gynecological malignant tumors,and 17 patients were complicated with cervical intraepithelial neoplasia.84 patients,with a follow-up period of 36-180 months,had no recurrence.Conclusions:The incidence of cervical endometriosis is insidious,most of which have no clinical symptoms.It can cause infection,a lot of vaginal bleeding and other symptoms.Because it can become malignant or coexist with gynecological malignant diseases,it needs clinical attention.

关 键 词：宫颈子宫内膜异位症 病理学 临床特点 诊断 治疗 预后 

分 类 号：R711.71[医药卫生—妇产科学]