子宫内膜息肉的发病特点、恶变及治疗研究进展

Development of epidemiology,malignancy and treatment of endometrial polyps

复习近几年有关的国内外文献,阐述子宫内膜息肉的发病特点、恶变情况及治疗等方面的研究进展。子宫内膜息肉好发于成年人,其发生率随年龄的增大而升高,并在异常子宫出血、不孕症、肥胖和绝经等人群中发病率较高。有少数息肉不予治疗即可自然消失。虽然对年轻患者的、无症状的和直径小的息肉可以进行期待治疗,但须慎重。TCRP术是治疗EP最好的方法,对无生育要求的高危患者应同时行TCRE术。不孕患者息肉切除后可明显提高妊娠率。另外,不要忽视息肉的非典型增生与恶变,在绝经后异常子宫出血者中,4.47%为癌性息肉,在无症状绝经后妇女中为1.51%。生育年龄EP的恶变率低于绝经后EP。正确认识子宫内膜息肉的发病特点与恶变对于子宫内膜息肉的治疗是非常重要的。

A review of domestic and international literature about recent years were conducted.The development of endometrial polyps on epidemiology,malignancy and treatment were expounded.Endometrial polyp was a disorder of aging and the incidence increased with age.There was higher incidence in the patients with abnormal uterine bleeding,infertility,fatty and menopause.A small number of polyps could vanish when left untreated.The asymptomatic and small polyps of young patients could be treated expectantly,but it must be taken seriously.The best surgical treatment was trartscervical resection of polyp.Trartscervical resection of endometrium should be performed at the same time for the patients with high risk factor without fertility requirements.The pregnancy rate would increase after the polyps were resected.In addition,the atypical hyperplasia and malignancy should not be neglected.Among symptomatic and asymptomatic postmenopausal women with endometrial polyps,incidence of malignant polyp was 4.47% and 1.51% respectively.It is very important to know the development of endometrial polyps on epidemiology,malignancy and treatment correctly.