资源描述:
《子宫腺肌病及子宫肌瘤临床比较》由会员上传分享,免费在线阅读,更多相关内容在工程资料-天天文库。
1、子宫腺肌病及子宫肌瘤临床比较【摘要】目的探讨子宫腺肌病与子宫肌瘤的临床特点,提高对于子宫腺肌病术前诊断率。方法以5年来妇产科子宫切除术后病理证实为子宫腺肌病的130例为A组;并随机选择同期子宫切除术后病理证实的子宫肌瘤患者150例为B组,对2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2组患者均好发于生育年龄妇女,常有月经过多或经期延长(P>;0.05)o子宫腺肌病术前诊断率(72.31%),出现痛经(73.08%)、性交痛较多(33.08%),但继发性贫血少(15.38%);具有特征性的超声表现;血清CA125
2、(74.5±68.3)U/ml,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术前鉴别。【关键词】子宫腺肌病;子宫肌瘤;诊断,鉴别[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近年来,子宫腺肌病的发病有
7、上升趋势,发病率&8%〜31.0%[1],已成为妇产科的常见病之一,与子宫肌瘤在临床上有许多相似之处,常合并存在,但两者发病机理、治疗原则不同,因此术前明确诊断非常必要。本文拟从这两种疾病的既耐药原因也主要是SEP产生ermC基因编码[6]。D试验阳性率23.33%说明用红霉素后诱导克林霉素耐药比较高,与沈定霞,罗燕萍,许雅萍,等报道[7]葡萄球菌对红霉素和克林霉素的诱导耐药性研究结果近似,说明用红霉素后选择克林霉素必须检测D试验。当B内酰胺类抗生素耐药或红霉素或是克林霉素必须做D试验,只有D试验阴性方可选用克林霉素。从实验结果中看出对于左氧氟沙星耐药性同样
8、比较高,产生耐药原因主要是SEP耐药的质粒的传导。试