子宫腺肌病与子宫肌瘤的临床比较

目的探讨子宫腺肌病与子宫肌瘤的临床特点及B超、实验室检测的价值,提高对子宫腺肌病术前的诊断率。方法选择5年来我院妇产科子宫切除术后经病理证实的子宫腺肌病患者120例为子宫腺肌病组,随机选择同期子宫切除术后经病理证实的子宫肌瘤患者120例为子宫肌瘤组,对两组患者年龄分布、既往史、临床症状、术前诊断、B超检查、血清CA125水平进行比较。结果两种疾病均好发于生育年龄妇女,常有月经过多或经期延长,经分析差异无显著性(P>0.05)。子宫腺肌病术前诊断率56.1%,出现痛经、性交痛较多,但继发性贫血少;具有特征性的超声表现;血清CA125水平明显升高。结论子宫腺肌病诊断的金标准是病理诊断,但其既往史、特有症状、B超改变、血清CA125水平增高仍是诊断该病的重要参考指标,并可与子宫肌瘤进行手术前鉴别。

Clinical comparison between adenomyosis and hysteromyoma

Objective To explore the preoperative diagnosis of adenomyosis by comparing the clinical characteristics of adenomyosis and hysteromyoma and investigating the application of ultrasonography B and laboratory tests. Methods Comparisons were made in age distribution, pathological history, clinical symptom, preoperative diagnosis, ultrasonic B test and serum CA125 level between two groups: 120 cases of adenomyosis and 120 cases of hysteromyoma selected randomly from patients treated in our hospital during past 5 years. Results Significant differences were not observed in incident rate for these two diseases among both groups of patients tested (P>0.05). Both diseases are subject to occur for women at reproductive age and share some clinical manifestations such as menorrhagia and / or menostaxis. The preoperative diagnosis rate is 56.1% for adenomyosis. The characteristic symptoms of adenomyosis include more frequent algomenorrhae and dyspareunia, less likely secondary anemia, distinct characteristics in ultrasonography B, and the elevated selum CA125 levels. Conclusion Pathological diagnosis is the golden standard to diagnose adenomyosis, but pathological history, clinical symptom, change of ultrasonography B and the increased serum CA125 levels are important reference index to differentiate adenomyosis from hysteromyoma, particularly before the operation.