子宫内膜腺肌瘤性息肉的诊治分析

Analysis of diagnosis and treatment of adenomyomatous endometrial polyp

目的探讨宫腔镜诊治子宫内膜腺肌瘤性息肉的临床应用。方法分析42例子宫内膜腺肌瘤性息肉患者的诊治及预后。结果诊断子宫内膜腺肌瘤性息肉的敏感度宫腔镜检查57.14%,B超35.71%,二者差异有显著性(P<0.05)。误诊为子宫黏膜下肌瘤率宫腔镜检查42.86%,B超47.62%,二者差异无显著性(P>0.05)。全部患者均行宫腔镜子宫内膜息肉切除术,术后随访1～10年,无任何病例复发。5例非典型息肉样腺肌瘤患者预后良好。结论宫腔镜是诊治子宫内膜腺肌瘤性息肉的最好方法;非典型息肉样腺肌瘤患者,必要时术后辅以高效孕酮治疗。

[Objective] To investigate the clinical diagnosis and treatment of adenomyomatous endometrial polyp by hysteroscope. [Methods] Clinical data of 42 patients with adenomyomatous endometrial polyp were analyzed. [Results] All cases underwent hysteroscopy and B ultrasound before operation. The sensitivity was 57.14% and 35.71%, respectively. They showed significant difference （P〈0.05）. The false diagnosis rate of uterine submucous myoma was 42,86% and 47.62% respectively. They showed no significant difference （P〉0.05）. All cases were followed up after transcervical resection of polyp （TCRP） from 1 year to 10 years. No recurrence after operation was observed. 5 cases with atypical polypoid adenomyoma of uterus had good prognosis. [Conclusion] The data suggests that hysteroscopy and TCRP is the best choice for adenomyomatous endometrial polyp. The assistant progesterone treatment is sometimes necessary for patients with atypical polypoid adenomyoma after operation.