摘要
目的研究绝经后增大的子宫肌瘤的临床表现及病理特征。方法选取2014年1月至2016年1月首都医科大学附属北京妇产医院经手术治疗的86例绝经后子宫肌瘤增大患者为研究对象,分析其临床临床表现、合并其他妇科疾病情况、手术病理情况以及子宫肌瘤变性与患者年龄、绝经年限、肌瘤直径、肌瘤类型、血流信号的相关性。结果 86例患者中无明显症状者61例,阴道出血者11例、腹痛者6例、下腹坠胀者4例、尿频者4例。子宫肌瘤发生变性者20例,其中玻璃样变17例、红色变1例、黏液变性1例、脂肪变性1例。子宫肌瘤变性与患者年龄、绝经年限、肌瘤直径、肌瘤类型、肌瘤有无血流信号无关(P>0.05)。特殊类型子宫肌瘤10例,其中子宫脂肪平滑肌瘤5例、富于细胞型平滑肌瘤3例、静脉内平滑肌瘤1例、奇异型平滑肌瘤1例。低度恶性子宫内膜间质-平滑肌肿瘤1例。子宫肌瘤合并子宫内膜增生6例,其中单纯性增生2例、复杂性增生1例、非典型性增生3例;合并子宫内膜息肉1例;合并卵巢肿物18例,其中浆液性囊腺瘤15例、卵巢单纯囊肿1例、子宫内膜异位囊肿1例。结论绝经后增大的子宫肌瘤大多无症状,有症状者以阴道出血多见。肿瘤本身恶性病变的发生率低,对无症状患者可严密随访,对有症状的患者应高度重视,积极治疗。
Objective To investigate the clinical and pathological characteristics of growing uterine leiomyoma in post- menopausal women. Methods A total of 86 postmenopansal patients with growing uterine leiomyoma treated by operation in Beijing Obstetrics and Gynecology Hospital from Jan. 2014 to Jan. 2016 were collected, to investigate the clinical manifesta- tion ,existence of other gynecological diseases, surgical pathology and the relationship between patients age, menopausal period, myoma diameter and blood flow signal. Results Among the 86 patients, asymptomatic 61 cases,vaginal hemorrhage 11 cases, abdominal pain 6 cases, hypogastrium bulge 4 cases, frequent micturitio 4 cases. There were 20 cases with degen- eration,including 17 cases of hyaline degeneration, 1 case of red degeneration, 1 case of mucinous degeneration and 1 case of fatty degeneration. There was no correlation between uterine leiomyoma degeneration and age, menopausal year, leiomyoma diameter, leiomyoma type, leiomyoma blood signals （ P 〉 0.05 ）. There were 10 cases of special types of uterine leiomyomas, including 5 cases of uterine lipoleiomyomas,3 cases of cellular leiomyomas, 1 case of intravenous leiomyomatosis and 1 case of bizarre leiomyoma. There was 1 case of low-grade endometrial stroma-smooth muscle tumour. There were 6 cases of hyste- romyoma combined with endometrial hyperplasia, including 2 cases of simple hyperplasia, 1 case of complex hyperplasia and 3 cases of atypical hyperplasia. There was 1 case accompanied with endometrial polyp, 18 cases accompanied with ovarian tumors,including 15 cases with serous cystadenoma, 1 case with simple ovarian cyst and 1 case with endometriotic cyst. Conclusion Most of postmenopausal patients with growing uterine leiomyoma are symptomless,while the common symptom is vaginal hemorrhage. The incidence of malignant lesions of postmenopausal growing uterine leiomyoma is low. The patients without symptoms should receive Close follow-up, more attention should be paid to the patients with symptoms and active treatment should be delivered.
作者
张博
叶红
ZHANG Bo YE Hong.(Department of Minimally Invasive Gynecology,Bering Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100006, China)
出处
《医学综述》
2017年第18期3717-3720,共4页
Medical Recapitulate
关键词
子宫肌瘤
绝经后
临床表现
子宫肌瘤变性
Hysteromyoma
Postmenopausal
Clinical manifestation
Uterine myoma degeneration
