[1]宋菁华 郭红燕* 韩钦 于博.25例子宫非典型息肉样腺肌瘤的临床特征分析[J].中国微创外科杂志,2023,01(10):731-735.
　Song Jinghua,Guo Hongyan,Han Qin,et al.Clinical Feature Analysis of 25 Cases of Atypical Polypoid Adenomyoma[J].Chinese Journal of Minimally Invasive Surgery,2023,01(10):731-735.
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25例子宫非典型息肉样腺肌瘤的临床特征分析()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2023年10期
页码:
731-735
栏目:
临床研究
出版日期:
2023-10-25

文章信息/Info

Title:
Clinical Feature Analysis of 25 Cases of Atypical Polypoid Adenomyoma
作者:
宋菁华 郭红燕* 韩钦 于博
(北京大学第三医院妇产科，北京100191)
Author(s):
Song Jinghua;  Guo Hongyan;  Han Qin;  et al.
Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
关键词:
子宫非典型息肉样腺肌瘤; 宫腔镜
Keywords:
Atypical polypoid adenomyoma; Hysteroscopy
文献标志码:
A
摘要:
目的探讨子宫非典型息肉样腺肌瘤(atypical polypoid adenomyoma，APA)的临床病理特征及诊疗方案。方法回顾性分析2010年1月~2022年1月我科收治25例APA的临床资料，宫腔镜手术后18例保守治疗，7例手术治疗，随访预后情况。结果宫腔镜下完整切除宫腔内病灶25例。术后病理均为APA，其中8例合并子宫内膜不典型增生，7例合并子宫内膜样癌，2例合并子宫内膜息肉，1例合并子宫颈息肉。18例宫腔镜手术后进行保守治疗，7例宫腔镜手术后切除子宫(3例行腹腔镜全子宫切除+双侧附件/双侧输卵管切除术，4例行腹腔镜全子宫切除+双侧附件切除+盆腔淋巴结切除+腹主动脉旁淋巴结活检术)。24例术后随访(42.8±28.7)月，1例宫腔镜术后(接受保守治疗)76个月因多发子宫肌瘤行腹腔镜全子宫切除+双侧输卵管切除术，余23例均无异常。结论APA多发生于育龄期女性，需通过病理学确诊。APA恶性潜能低，有生育要求者可进行保守性宫腔镜手术治疗，术后密切随访。全子宫切除术是无生育要求的APA患者首选治疗方案。
Abstract:
ObjectiveTo study clinical pathological characteristics and diagnosis and treatment of atypical polypoid adenomyoma (APA).MethodsA retrospective study was made on 25 patients with APA in our department from January 2010 to January 2022. After hysteroscopic surgery, 18 cases were treated conservatively and 7 cases were treated surgically. The prognosis was followed up.ResultsAll the 25 patients underwent complete hysteroscopic resection of intrauterine lesions. The postoperative pathology was APA, including 8 cases with endometrial dysplasia, 7 cases with endometrial cancer, 2 cases with endometrial polyp, and 1 case with cervical polyp. Conservative treatment was performed in 18 cases and hysterectomy was performed in 7 cases (3 cases of laparoscopic hysterectomy plus bilateral adnexectomy/salpingectomy, 4 cases of laparoscopic hysterectomy plus bilateral adnexectomy plus pelvic lymph node resection plus paraaortic lymph node biopsy). A total of 24 cases were followed up for (42.8±28.7) months after surgery. One case underwent laparoscopic hysterectomy plus bilateral salpingectomy for multiple uterine myoma after conservative treatment for 76 months. And the other 23 cases were normal.ConclusionsAPA usually occurs in women of childbearing age, and its diagnosis is based on pathological morphology. APA has a low malignant potential, and those who have fertility requirements can undergo conservative hysteroscopy treatment and close followups. Total hysterectomy is the treatment of choice for APA patients without fertility requirements.

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备注/Memo

备注/Memo:
*通讯作者，Email：bysyghy@163.com
更新日期/Last Update: 2024-01-08