较大囊性子宫腺肌病2例报告并文献复习

发布时间：2018-01-04 04:17

本文关键词：较大囊性子宫腺肌病2例报告并文献复习　出处：《山东大学》2015年硕士论文　论文类型：学位论文

【摘要】：背景及目的子宫腺肌病是指子宫内膜良性生长于子宫肌层导致的子宫弥漫性增大,在镜下表现为子宫肌层中出现异位非新生的子宫内膜腺体及间质,周围伴有平滑肌细胞的增生肥大。患者多主诉月经量增多、较严重的痛经或不孕,根据病理学诊断的子宫腺肌病患者,年龄多在40-50岁,痛经及经血过多是子宫腺肌病患者最常见的临床症状,子宫腺肌病严重影响女性的身心健康。子宫腺肌症有不同的类型,其中囊性子宫腺肌病比较少见,直径大于3cm的囊性腺肌病更加罕见。通过对较大囊性子宫腺肌病的病例分析,我们可以了解其临床特点,结合临床表现及相关的影像学检查,用以探讨较大囊性子宫腺肌病的诊断和鉴别诊断,并进一步分析子宫腺肌病的分类和发病机制。材料与方法收集2014年由山东大学齐鲁医院妇产科诊断并治疗的2例较大囊性子宫腺肌病患者的临床病例资料并进行分析,结合相关医学文献,深入探讨该类疾病的病理表现、发病机制、临床表现、影像学特点、诊断及鉴别诊断,并进行归纳总结。结果2例病例根据其临床表现及相关影像学检查,初步诊断为囊性子宫腺肌病,完善相关检查后实施腹腔镜手术,术中均见囊内为巧克力样液体,完整剥除囊肿,病理学检查示局部查见异位的子宫内膜,诊断为宫壁子宫内膜异位囊肿,术后给予患者GnRH-a治疗6个月,随诊至今无复发。结论子宫腺肌病好发于中年女性,无性生活史青少年病例临床并不常见,尤其是较大囊性子宫腺肌病更加罕见。较大囊性子宫腺肌病应与子宫畸形相鉴别。囊性子宫腺肌病患者的痛经症状比较严重,临床医师应提高对该类疾病的了解和认识。手术是治疗较大囊性子宫腺肌病的首选治疗方法。
[Abstract]:Background and objective: adenomyosis is a kind of benign uterine growth in myometrium uterus caused by diffuse enlargement, the microscope showed that endometrial glands in myometrium heterotopic non newborn and interstitial hyperplasia, surrounded by smooth muscle cells. Many patients complained of menorrhagia, severe dysmenorrhea or infertility, according to the pathological diagnosis of patients with adenomyosis, at the age of 40-50 years, dysmenorrhea and menorrhagia is the most common clinical symptoms of patients with adenomyosis adenomyosis, serious impact on women's physical and mental health. There are different types of adenomyosis, including cystic adenomyosis is relatively rare, diameter greater than 3cm cystic adenomyosis more rare. Based on a large cystic adenomyosis case analysis, we can understand its clinical characteristics, histological examination combined with clinical manifestations and related images, in order to explore the large The diagnosis and differential diagnosis of cystic adenomyosis, and further analysis of the classification and pathogenesis of adenomyosis. Materials and methods from 2014 from Qilu Hospital of Shandong University Department of Obstetrics and Gynecology, diagnosis and treatment of 2 cases of cystic adenomyosis in patients with clinical data were analyzed, combined with the relevant medical literature, in-depth study of pathological features. This kind of disease pathogenesis, clinical manifestations, imaging features, diagnosis and differential diagnosis, and summarized. Results 2 cases according to the clinical manifestation and imaging examination, the initial diagnosis of cystic adenomyosis, perfect relevant examination after laparoscopic surgery, the cyst is chocolate like liquid surgery in the enucleation of cyst, pathological examination showed local found ectopic endometrium, diagnosed as uterine wall endometriosis cyst, postoperative patients were given GnRH-a treatment for 6 months follow-up No recurrence. Conclusion adenomyosis occurs in middle-aged women, sexual life youth cases are not common, especially large cystic adenomyosis more rare. Large cystic adenomyosis and uterine malformation. Differentiate cystic adenomyosis patients with dysmenorrhea symptoms more serious, clinicians should improve the this kind of disease understanding. Surgery is the preferred method for treatment of large cystic adenomyosis.

【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R711.71

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