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1、子宮腺肌病及子宮肌瘤臨床比較【摘要】目的探討子宮腺肌病與子宮肌瘤的臨床特點(diǎn),提高對(duì)于子宮腺肌病術(shù)前診斷率。方法以5年來(lái)婦產(chǎn)科子宮切除術(shù)后病理證實(shí)為子宮腺肌病的130例為A組;并隨機(jī)選擇同期子宮切除術(shù)后病理證實(shí)的子宮肌瘤患者150例為B組,對(duì)2組患者年齡分布、既往史、臨床癥狀、術(shù)前診斷,B超檢查、血清CA125水平進(jìn)行比較。結(jié)果2組患者均好發(fā)于生育年齡婦女,常有月經(jīng)過多或經(jīng)期延長(zhǎng)(P>;0.05)o子宮腺肌病術(shù)前診斷率(72.31%),出現(xiàn)痛經(jīng)(73.08%)、性交痛較多(33.08%),但繼發(fā)性貧血少(15.38%);具有特征性的超聲表現(xiàn);血清CA125
2、(74.5±68.3)U/ml,水平明顯升高。結(jié)論子宮腺肌病診斷的金標(biāo)準(zhǔn)是病理診斷,但其既往史、特有癥狀、B超改變、血清CA125水平增高仍是診斷該病的重要參考指標(biāo),并可與子宮肌瘤進(jìn)行術(shù)前鑒別。【關(guān)鍵詞】子宮腺肌?。蛔訉m肌瘤;診斷,鑒別[Abstract]ObjectiveToinvestigatedifferencesinclinicalcharacteristicsofadenomyosisandhysteromyomasoastoimprovepreoperativediagnosisrateofadenomyosis.Methods130caseso
3、fadenomyosisconfirmedbypathologicalexaminationafterhysterectomyinpast5yearsand150casesofhysteromyomaconfirmedbypathologicalexaminationafterhysterectomyinthesameperiodwererandomlyselectedandtheiragedistribution,pasthistory,clinicalsymptoms,preoperativediagnosis,ultrasonographicfindi
4、ngsandserumlevelofCA125werecompared.ResultsBoththediseaseswerecommonlyseeninwomenofchildbearingageandtheclinicalmanifestotionsofthepatientswerehypermenorrheaorprolongedmenstrualperiod(Nodifferencebetweenthetwogroups,P&百t;0.05)?Thepreoperativediagnosisrateofadenomyosiswas72.31%,andt
5、hepatientswithadenomyosisusuallysufferedfromdysmenorrhea(73?08%),dyspareunia(33?08%)andseldomsecondaryanemia(15?38%).UltrasonographicexaminationshowedsomecharacteristicfindingsandtheserumlevelofCA125(74.5±68?3U/ml)increasedevidently.ConclusionThoughthegoldenstandardofdiagnosisofade
6、nomyosisispathologicdiagnosis,thepasthistory,specificclinicalsymptoms,ultrasonographicfindings,andelevatedserumCA125levelarealsoimportaritreferenceindexestodifferentiateadenomyosiswithhysteromyomabeforeoperation.【Keywords】Adenomyosis;Hysteromyoma;Diagnosis,differential近年來(lái),子宮腺肌病的發(fā)病有
7、上升趨勢(shì),發(fā)病率&8%?31.0%[1],已成為婦產(chǎn)科的常見病之一,與子宮肌瘤在臨床上有許多相似之處,常合并存在,但兩者發(fā)病機(jī)理、治療原則不同,因此術(shù)前明確診斷非常必要。本文擬從這兩種疾病的既耐藥原因也主要是SEP產(chǎn)生ermC基因編碼[6]。D試驗(yàn)陽(yáng)性率23.33%說(shuō)明用紅霉素后誘導(dǎo)克林霉素耐藥比較高,與沈定霞,羅燕萍,許雅萍,等報(bào)道[7]葡萄球菌對(duì)紅霉素和克林霉素的誘導(dǎo)耐藥性研究結(jié)果近似,說(shuō)明用紅霉素后選擇克林霉素必須檢測(cè)D試驗(yàn)。當(dāng)B內(nèi)酰胺類抗生素耐藥或紅霉素或是克林霉素必須做D試驗(yàn),只有D試驗(yàn)陰性方可選用克林霉素。從實(shí)驗(yàn)結(jié)果中看出對(duì)于左氧氟沙星耐藥性同樣
8、比較高,產(chǎn)生耐藥原因主要是SEP耐藥的質(zhì)粒的傳導(dǎo)。試