国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2017, Vol. 36 ›› Issue (4): 295-299.

• 论著 • 上一篇    下一篇

子宫非典型息肉样腺肌瘤九例临床分析及文献复习

董珍珠，林婷婷，许淑霞，许沐，刘达宾，孙蓬明   

  1. 350001  福州，福建省妇幼保健院，福建医科大学附属医院
  • 收稿日期:2017-02-06 修回日期:2017-03-11 出版日期:2017-07-15 发布日期:2017-07-15
  • 通讯作者: 孙蓬明，E-mail: sunfemy@hotmail.com E-mail:sunfemy@hotmail.com
  • 基金资助:
    国家人事部2007年度留学人员科技活动项目择优资助课题（国人厅发[2007]170号）

Clinical Analysis of 9 Cases of Atypical Polypoid Adenomyoma and Literature Review

DONG Zhen-zhu, LIN Ting-ting, XU Shu-xia, XU Mu, LIU Da-bin, SUN Peng-ming   

  1. Fujian Provincial Maternity and Children Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, China
  • Received:2017-02-06 Revised:2017-03-11 Published:2017-07-15 Online:2017-07-15
  • Contact: SUN Peng-ming, E-mail: sunfemy@hotmail.com E-mail:sunfemy@hotmail.com

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摘要： 目的：探讨子宫非典型息肉样腺肌瘤（atypical polypoid adenomyoma，APA）的治疗和随访策略。方法：对我院2008—2016年收治的9例APA患者的临床资料进行回顾性分析。结果：9例患者的平均年龄为37.4（20～50）岁。其中3例为单纯APA；1例为APA合并子宫内膜样腺癌；1例为APA合并子宫内膜不典型增生；1例为APA，而后随访病理为子宫内膜复杂型不典型增生；1例为子宫内膜复杂型不典型增生，而后随访病理为APA与子宫内膜复杂型不典型增生共存；1例为APA，而后随访病理为子宫内膜复杂型增生；1例为APA与子宫内膜复杂型增生并存。3例初始治疗为分段诊刮术，6例为经宫腔镜病灶切除。随访截至2017年1月，平均随访45.5（3～103）个月，9例APA患者均未见复发、癌变，3例原发不孕患者均尚未妊娠。结论：APA临床上虽为良性疾病，但由于其潜在恶性应积极治疗，而且其治疗方案应依据患者年龄、腺体组织结构异型指数、子宫内膜情况以及是否有生育要求来决定。

关键词: 非典型息肉样腺肌瘤, 宫腔镜, 孕激素类, 治疗, 随访研究

Abstract: Objective: To discuss the treatment and follow-up strategy of atypical polypoid adenomyoma (APA) based on 9 cases and a mini review. Methods: The clinical data of 9 cases with APA admitted in our hospital (2008 to 2016) were retrospectively analyzed. Results: The average age of 9 cases is 37.4 (20-50), years old. Among 9 cases, 3 cases were simple APA, 1 case was APA complicated with endometrioid adenocarcinoma, 1 case was APA complicated with endometrial complex atypical hyperplasia; 1 case was APA ended up with endometrial complex atypical hyperplasia; 1 case was endometrial complex atypical hyperplasia，ended up with APA complicated with endometrial complex atypical hyperplasia; 1 case was APA ended up with endometrial complex hyperplasia; 1 case was APA complicated with endometrial complex hyperplasia. 3 cases were treated with fractional curettage, and 6 cases with hysteroscopic resection as the initial treatment. All cases underwent the follow-up visit 45.5(3-103) months, and no relapse and canceration were observed until January 2017. 3 cases of APA with primary infertility didn′t achieve their pregnances. Conclusions: Although APA is a benign disease, it should be treated actively because of its potential malignancy. The treatment strategy is related to many factors, such as age, the architectural index of the gland, endometrium situation and fetility demand.

Key words:  Atypical polypoid adenomyoma, Hysteroscopes, Progestins, Therapy, Follow-up studies