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目的探讨超声发现的宫腔回声团的临床处理原则。方法回顾性分析2006年1月至2008年1月间因宫腔回声团在北京大学人民医院妇科行宫腔镜手术的362例患者的临床资料,根据病理结果将患者分为Ⅰ组(正常内膜组),Ⅱ组(良性病变)和Ⅲ组(子宫内膜癌及癌前病变),对各组的临床特征、病史及超声所见进行分析。结果Ⅰ组患者68例(18.78%),年龄(38.23±13.01)岁,回声团直径中位数为0.95cm,低阻血流仅1例(1.5%)。Ⅱ组中267例(73.76%),年龄(45.35±11.73)岁,回声团直径中位数1.70cm,低阻血流8例(3%)。Ⅲ组中患者27例(7.46%),年龄(56.96±10.62)岁,回声团直径中位数为3.25cm,低阻血流17例(63.0%)。Ⅲ组中绝经后阴道出血、糖尿病病史、恶性肿瘤家族史发生率明显高于Ⅰ、Ⅱ组。结论对宫腔回声团患者的处理应个体化,根据情况可以选择定期超声随访、药物治疗或宫腔镜手术。
Objective To investigate the principle of clinical treatment of uterine cavity echo detected by ultrasound. Methods The clinical data of 362 patients undergoing hysteroscopic gynecological surgery at Peking University People’s Hospital from January 2006 to January 2008 were retrospectively analyzed. Patients were divided into group Ⅰ (normal endometrium Group), group Ⅱ (benign disease) and group Ⅲ (endometrial cancer and precancerous lesions). The clinical features, medical history and the findings of ultrasound were analyzed. Results There were 68 cases (18.78%) in group Ⅰ, with an age of (38.23 ± 13.01) years. The median diameter of echogenic group was 0.95 cm and only 1 case of low resistance blood flow (1.5%). There were 267 cases (73.76%) in group Ⅱ, with a mean age of 45.35 ± 11.73 years, a median diameter of echo group of 1.70 cm, and a low resistance blood flow of 8 cases (3%). There were 27 patients (7.46%) in group Ⅲ, with a mean age of 56.96 ± 10.62 years. The median diameter of echogenic group was 3.25 cm, and 17 cases (63.0%) had low resistance blood flow. Group Ⅲ postmenopausal vaginal bleeding, diabetes history, the incidence of family history of malignant tumors was significantly higher than Ⅰ, Ⅱ group. Conclusion The treatment of patients with uterine echo group should be individualized, according to the situation can choose regular follow-up, drug treatment or hysteroscopic surgery.