多发性子宫肌瘤合并腺肉瘤1例分析

Analysis of a Case with Multiple Myomata and Adenosarcoma

目的探讨多发性子宫肌瘤合并腺肉瘤的临床治疗方法与效果。方法选取于2017年3—4月来该院治疗的1例多发性子宫肌瘤合并腺肉瘤患者,对其行宫腔镜检查+子宫内膜息肉切除+分段诊刮术的方法治疗,观察患者的手术时间、术中出血量、病检结果与术后血常规检测结果。结果患者所用手术时间为30 min,术中出血量为50 mL,流出液为2 300 mL;WBC为5.12×10~9/L、PLT 150×10~9/L与手术术前检查结果差异无统计学意义;RBC 3.53×10^(12)/L、HB 73 g/L与术前检测相比均有所下降。经过宫腔镜检查+子宫内膜息肉切除+分段诊刮术的方法治疗后,送病检经检查发现患者子宫异常出血,考虑患有多发性子宫肌瘤、腺肉瘤以及中度贫血等症状,后行宫腔镜电切术病检治疗方式。结论经电切病检确诊为腺肉瘤合并子宫肌瘤,恰当正确的手术治疗方式,进一步行手术治疗。患者的子宫内膜息肉得到有效治疗。

Objective To study the clinical treatment method and effect of multiple myomata and adenosarcoma. Methods A case with multiple myomata and adenosarcoma in our hospital from March to April 2017 were selected and treated with hysteroscopy, endometrial polyp and fractional curettage surgery, and the operation time, intraoperative bleeding amount,pathological results and postoperative routine results of patients were observed. Results The operation time, intraoperative bleeding amount and effluent liquid were respectively 30 min, 50 mL, 2 300 mL, and the WBC and PLT after operation were respectively 5.12×10^9/L and 150×10^9/L, and the differences before and after operation were not obvious, and the RBC and HB after operation were respectively 3.53×10^（12）/L and 73 g/L, which decreased compared with those before operation, after the treatment, the pathological results showed that the patients had abnormal uterine bleeding, and the patients were considered multiple myomata, adenosarcoma and moderate anemia, and the hysteroscopic electric resection were then conducted. Conclusion The adenosarcoma and hysteromyoma are confirmed by the electrosurgical examination, and the endometrial polyps of patients are effectively treated by the accurate and proper operation treatment method.