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目的探讨子宫内膜腺肌瘤性息肉(adenomyom-atous endometrial polyp)的临床特点及诊治方法。方法选取我科2012年11月至2013年11月行TCRP手术并术后病理证实为子宫内膜腺肌瘤性息肉患者31例,回顾性分析其临床资料。结果 31例均行宫腔镜下息肉切除术,无手术并发症发生。31例患者的年龄为33~66岁,平均年龄48.72岁,其中绝经患者21例(占67.74%)。21例绝经期患者中非典型腺肌瘤性息肉8例,其中4例合并子宫内膜单纯性增生;4例合并子宫内膜轻-中度非典型性增生行腹腔镜下全子宫及双附件切除,术中冰冻其中2例为高分化子宫内膜样腺癌行腹腔镜下子宫内膜癌分期术。10例生育年龄患者中非典型腺肌瘤性息肉3例,1例合并子宫内膜复杂性增生,2例合并子宫内膜复杂性及非典型性增生,口服高效孕酮治疗后再次内膜活检无异常。结论宫腔镜结合病理是诊治子宫内膜腺肌瘤性息肉的可靠方法,非典型腺肌瘤性息肉的患者需手术治疗或辅以高效孕酮治疗。
Objective To investigate the clinical features and diagnosis and treatment of adenomyom-atomic endometrial polyp. Methods Totally 31 patients with endometrial adenomyosis who underwent TCRP from November 2012 to November 2013 were retrospectively analyzed. Results 31 cases underwent hysteroscopic polypectomy without complications. The age of 31 patients ranged from 33 to 66 years, with an average age of 48.72 years, of whom 21 (or 67.74%) had menopause. Among the 21 cases, atypical adenomyosis polyps were found in 8 cases, of which 4 cases were accompanied with simple hyperplasia of the endometrium; 4 cases were complicated with mild to moderate endometrial hyperplasia with laparoscopic total uterus and double attachment Excision, intraoperative frozen 2 cases of highly differentiated endometrial adenocarcinoma of laparoscopic endometrial cancer staging. 3 cases of atypical adenomyosis polyp in 10 cases of childbearing age, 1 case complicated with complicated endometrial hyperplasia, 2 cases complicated with endometrial complex and atypical hyperplasia, No abnormality. Conclusion Hysteroscopy combined with pathology is a reliable method of diagnosis and treatment of endometrial adenomyosis polyp. Patients with atypical adenomyosis need surgical treatment or supplemented with high-efficiency progesterone.