【摘要】 目的:探讨不同组织类型子宫肉瘤的临床特点,提高对该病的诊治效果。方法:回顾性分析我院34例子宫肉瘤的临床资料,其中子宫内膜间质肉瘤19例(55.8%),子宫平滑肌肉瘤6例(18%),子宫癌肉瘤9例(26%)。结果:(1)子宫肉瘤平均发病年龄46岁左右,子宫内膜间质肉瘤发病28~60岁,年轻妇女易受累,癌肉瘤患者年龄较大(56±9.6)岁,多发生于绝经后女性,发病率占55.8%,以子宫内膜间质肉瘤多见。(2)子宫肉瘤最常见的表现是阴道不规则出血(76%),诊刮是最常采用的术前诊断,术前诊刮率为76%,诊刮阳性率为65.3%,术后病理确诊占34.7%。(3)26例行一期手术治疗,7例二期手术补充治疗;手术方式为子宫加双附件,及子宫双附件加盆腔淋巴清扫。随访5年生存率为77.7%(14/18)。结论:子宫肉瘤发病年龄范围较广,术前诊断可以依靠内膜诊刮病理确诊,诊刮也会导致漏诊,需重视术中检视,及时送冰冻检查提高诊断率,选择合适的手术方式,改善预后。更多还原

【Abstract】 Objective To analyze the clinical features of the uterine sarcoma with different histological types and improve the capability of diagnosis and therapy. Methods Thirty-four cases with uterine sarcoma treatment were analyzed respectively, among which there were 19 cases with malignant endometrial interstitial sarcomas(55.8%), 6 cases with leiomyosarcoma(18%), 9 with malignant mixed tumor(26%). Results(1)The average age of patients were about 46, patients with endometrial interstitial sarcomas aged 28 ~ 60 were more common in relatively younger, and patients with malignant mixed tumor aged about 56 were more common in postmenopausal women. Incidence rate of patients with endometrial interstitial sarcomas were more common(55.8%).(2) The patients usually manifested with abnormal vaginal bleeding(76%). Diagnosis curettage were the most commonly used before operation, which the positive rate was 65.3% and postoperative pathological diagnosis was 35%.(3) 26 patients underwent one stage surgical treatment.7 patients underwent two stage surgical treatment. Surgical methods were the removal of the uterine double accessories and pelvic lymph node dissection.The five year survival rate was 77.7%(14 / 18). Conclusions The age range of uterine sarcoma is more extensive. Preoperative diagnosis can be diagnosed by curettage, and may also be missed. It should be paid attention to the operation of the examination examination, timely delivery of frozen examination to improve the diagnostic rate. and the appropriate surgical choice are meaningful methods to improve the prognosis.更多还原