【摘要】 目的 探讨子宫肉瘤的临床特征，诊断及影响预后的相关因素，以提高临床诊治水平。方法 回顾性分析37例子宫肉瘤的临床特点、诊断、治疗及预后。结果 子宫肉瘤临床表现主要为异常阴道出血和腹部包块;诊断性刮宫和术中快速冰冻是明确诊断的主要方法;病理类型和治疗方式对子宫肉瘤患者2年及5年生存率无影响(P>0.05)。临床分期和年龄与子宫肉瘤患者2年及5年生存率有关(P<0.05)。结论 子宫肉瘤的临床症状不典型, 术前诊断率低,预后差;治疗以手术为主,可辅以放疗和化疗;临床分期和年龄是影响子宫肉瘤预后的重要因素。
【关键词】 子宫肉瘤;临床特征;预后
Clinical and prognosis factors analysis of 37 cases uterine sarcoma
ZHANG Yong-ming, ZHANG Xue-yu.(Ningxia Medical University, Yinchuan 750004, China)
[Abstract] Objective To analyze the clinical characteristics of uterine sarcoma to facilitate the earlier diagnosis and treatment.Methods Thirty seven cases with uterine sarcoma were retrospectively analyzed about the clinical features, diagnosis, therapy and prognostic factors.Results The patients usually manifested with abnormal vaginal bleeding and lower-abdominal mass; Diagnostic curettage and rapid frozen section examination during the operation were main methods for diagnosis. Pathologic type and chemotherapy were not correlated with the overall 2-year and 5-year survival rates of the patients (P>0.05). But clinical stage and ages of the patients were correlated with them (P<0.05).Conclusion The clinical symptoms of uterine sarcoma is not typical, the preoperative diagnosis rate is low and the prognosis is poor. The treatment is mostly by operation. Chemotherapy and radiotherapy are given after operation. The prognosis of uterine sarcoma was significantly related to clinical stage and patients age.
[Key words] Uterine Sarcoma; Clinical Characteristics; Prognosis
子宫肉瘤在女性生殖道恶性肿瘤中较为罕见,现对收治的37例子宫肉瘤作回顾分析。
1临床资料
1.1 一般资料：收集宁夏医科大学附属医院1995年1月-2005年6月期间收治的有完整病历资料和随访记录的子宫肉瘤临床资料37例，患者年龄23-73岁 (平均49.67岁),其中50岁及以上17例,60岁以上4例。绝经18例,已婚已产者34例, 曾孕未产者2例, 未婚1例。
1.2 术前检查：37例术前均行B超检查，其中诊断为子宫肌瘤或子宫肌腺症21例，宫腔占位7例，子宫内膜癌5例，子宫肉瘤4例。术前行盆腔CT检查者4例，仅有1例确诊。术前行血清肿瘤标记物CA125检查16例，4例升高，最高127.1mIU/L。
1.3 手术方式：本组资料术前诊刮确诊19例，术中冰冻确诊11例。其中17例行子宫及双附件切除术，13例行广泛或次广泛子宫及双
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