子宫颈子宫内膜异位症19例临床病理分析

Clinical analysis of 19 cases with cervical endometriosis

目的分析子宫颈子宫内膜异位症的临床表现及诊治特点,以指导临床工作。方法回顾性分析北京协和医院妇产科1993年1月至2007年12月间病理证实为子宫颈子宫内膜异位症的19例患者的临床资料。结果19例子宫颈子宫内膜异位症患者中,11例术前宫颈外观正常而术后病理切片提示病变,其中9例行全子宫切除术,2例行宫颈锥切术。术前宫颈外观异常8例患者中,3例表现为宫颈肿物,1例表现为宫颈息肉,4例表现为宫颈紫蓝色结节;6例患者主诉有不规则阴道出血和/或性交后出血;4例浅表的宫颈紫蓝色结节行结节切除术,宫颈肿物及息肉行病灶切除2例,全子宫切除2例。结论子宫颈子宫内膜异位症可伴阴道不规则出血或性交后出血。治疗方式的选择应根据病变的类型、患者的年龄及生育要求采取个体化的手段。

Objective To analyze the clinic characteristics of cervical endometriosis. Methods 19 cases of cervical endometriosis conformed by pathological examination were enrolled in a retrospective analysis. Results 11 cases were found incidentally in histological speciments after hysterectomy or conization. The other 8 cases were found to have lesions on/in cervix before operation： 4 cases had superficial and purple--blue lensions; 1 case had a polypoid mass in the posterior lip of cervix; 3 patients had mass originating from cervix. 6 of the 19 patients presen- ted with intramenstrual bleeding and/or postcoitcal bleeding. Hysterectomy was performed in 2 cases. Lesion exci- sion was made in 1 patient with polypoid mass and 1 patient with small cervical mass. The superficial lesion was ex- cised for the purpose to exclude the possibility of malignance in 4 patients. Conclusions Cervical endometriosis can cause intramenstrual bleeding or postcoitcal bleeding. The decision of management should be made individually, ac- cording to patient＇s age, the requirement for pregnancy and the type of lesion.