国际生殖健康/计划生育杂志

国际生殖健康/计划生育杂志 ›› 2026, Vol. 45 ›› Issue (1): 28-31.doi: 10.12280/gjszjk.20250325

• 病例报告 • 上一篇    下一篇

子宫囊性腺肌病一例

胡晓红, 令菲菲, 白耀俊, 李红丽, 刘畅()   

  1. 730000 兰州大学第一临床医学院（胡晓红，令菲菲，白耀俊）；兰州大学第一医院妇产科，甘肃省妇科肿瘤临床医学研究中心（李红丽，刘畅）
  • 收稿日期:2025-06-23 出版日期:2026-01-15 发布日期:2026-02-02
  • 通讯作者: 刘畅 E-mail:lch@lzu.edu.cn

A Case of Cystic Adenomyosis

HU Xiao-hong, LING Fei-fei, BAI Yao-jun, LI Hong-li, LIU Chang()   

  1. The First School of Clinical Medicine of Lanzhou University, Lanzhou 730000, China (HU Xiao-hong, LING Fei-fei, BAI Yao-jun); Department of Obstetrics and Gynecology, The First Hospital of Lanzhou University, Gansu Provincial Clinical Medical Research Center for Gynecological Oncology, Lanzhou 730000, China (LI Hong-li, LIU Chang)
  • Received:2025-06-23 Published:2026-01-15 Online:2026-02-02
  • Contact: LIU Chang E-mail:lch@lzu.edu.cn

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摘要：

子宫囊性腺肌病是一种罕见类型的子宫腺肌病，临床表现以进行性痛经和月经异常为核心，伴随慢性盆腔疼痛、性交痛及生育力下降。报告1例子宫囊性腺肌病病例，患者因间歇性下腹部疼痛3个月余就诊，结合盆腔MRI及糖类抗原125（carbohydrate antigen 125，CA125）初步诊断为子宫肌壁间子宫内膜异位囊肿，行宫腔镜下子宫内膜异位病灶切除术，术中见巧克力样积液流出，结合术后病理结果最终诊断为子宫囊性腺肌病。术后给予促性腺激素释放激素激动剂4个周期，术后随访5个月临床症状完全缓解，未复发。子宫囊性腺肌病临床表现具有显著异质性，超声、MRI及CA125是诊断该疾病的重要辅助方法。手术切除病灶是治疗的主要手段，术后辅助激素治疗可巩固手术效果、降低复发风险及改善生育预后。

关键词: 子宫腺肌病, CA-125抗原, 宫腔镜检查, 促性腺素释放激素, 病例报告

Abstract:

Cystic adenomyosis is a rare type of adenomyosis. Its clinical manifestations are characterized by progressive dysmenorrhea and menstrual abnormalities, accompanied by chronic pelvic pain, dyspareunia and decreased fertility. A case of cystic adenomyosis was reported. The patient was admitted for intermittent lower abdominal pain for more than 3 months. The pelvic MRI combined with carbohydrate antigen 125 (CA125) test suggested the diagnosis of uterine myometrium endometriosis cyst and underwent hysteroscopic resection of endometriosis lesions. Chocolate-like effusion was seen during the operation. With these findings and postoperative pathological results, the patient was diagnosed with cystic adenomyosis. The patient received four cycles of gonadotropin-releasing hormone agonist postoperatively. After 5 months of follow-up, the clinical symptoms were completely relieved and there was no recurrence. The clinical manifestations of cystic adenomyosis have significant heterogeneity. Ultrasound, MRI and CA125 are important auxiliary methods for the diagnosis of this disease. Surgical resection of the lesion is the main means of treatment. Postoperative adjuvant hormone therapy can consolidate the surgical effect, reduce the risk of recurrence and improve the prognosis of fertility.

Key words: Adenomyosis, CA-125 antigen, Hysteroscopy, Gonadotropin-releasing hormone, Case reports