巨大子宫内膜息肉自行脱落一例报告并文献复习

回顾分析1例黄体期子宫内膜巨大息肉(4 cm×2 cm×1 cm)自行剥脱临床资料,并对国内外子宫内膜息肉的相关文献进行归纳总结。子宫内膜息肉发病率高,但直径大于4 cm的子宫内膜息肉临床少见。绝大多数患者无临床症状,直径小于1 cm的子宫内膜息肉多为功能性息肉,有月经期自行剥脱的可能。子宫内膜息肉病因及发病机制不明确,其形成可能与雌孕激素受体失调、感染、炎症、氧化应激、细胞因子表达异常、细胞增殖与凋亡失衡有关。宫腔镜检查及宫腔镜下息肉切除术是目前治疗子宫内膜息肉最简单、有效的方法,临床上直径小于0.7 cm的息肉可期待治疗,药物治疗(雌孕激素或孕激素)及左炔诺孕酮宫内缓释系统(LNG-IUS)多用于宫腔镜术后复发的预防。

A Case Report of Giant Endometrial Polyps Shedding Spontaneously and Literature Review

The clinical data of 1 case of giant endometrial polyp(4 cm ×2 cm ×1 cm) shedding spontaneously in luteal stage were retrospectively analyzed, and the relevant literatures of endometrial polyp were reviewed. The incidence of endometrial polyps is high, however the endometrial polyps larger than 4 cm are rare in clinic. Most patients have no clinical symptoms. Those endometrial polyps smaller than 1 cm are mostly functional polyps, which may be stripped by themselves during menstruation. The etiology and pathogenesis of endometrial polyps are unclear, which is related to the imbalance of estrogen receptor and progesterone receptor, infection and inflammation, oxidative stress, abnormal expression of cytokines, and the imbalance of cell proliferation and apoptosis. Hysteroscopy and hysteroscopic polypectomy are the most simple and effective methods to treat endometrial polyps. Clinically, endometrial polyps smaller than 0.7 cm can be observed. Drug therapy(estrogenprogesterone or progesterone) and LNG-IUS are mostly used to prevent the recurrence of endometrial polyps after hysteroscopic surgery.