基层医院子宫肌瘤超声诊断分析.docVIP

基层医院子宫肌瘤超声诊断分析 　　[摘要] 目的:探讨经腹超声检查子宫肌瘤的可靠性。方法:回顾性分析2007年2月~2009年8月来我院就诊诊断为子宫肌瘤并经手术治疗的58例患者,且与术后病理切片对照。结果:超声诊断符合病理诊断52例,符合率为89.7%,超声诊断误诊6例,误诊率为10.3%。结论:经腹超声检查方法简单,经济实用,可作为地方基层医院初步筛?子宫肌瘤的手段。 　　[关键词] 子宫肌瘤;超声诊断;基层医院 　　[中图分类号]R737.33 [文献标识码] B[文章编号] 1673-7210(2010)06(b)-126-02 　　 　　Analysis of ultrasonography diagnosis in uterine sarcomas in elementary hospital 　　JING Jianghong1, JING Jiangxin2 　　(1.The Seond Hospital of Poverty Alleviation, Xinjiang Uygur Autonomous Region, Urumqi 830026, China; 2.The Seond Affilliated Hospital of Xinjiang Medical University, Urumqi 830063, China) 　　[Abstract] Objective: To investigate the reliability of examination uterine sarcomas in ultrasonography. Methods: The 58 cases operated patients were analyzed retrospectively and comparing them with ultrasound and pathologic characteristics from Febrary 2007 to Augest 2009. Results: The 52 cases that were diagnosed uterine sarcomas by pathologic were diagnosed by transvaginal ultrasound and the accurate rate of ultrasound was 89.7% and the error diagnosis was 6 cases, which rate was 10.3%. Conclusion: The ultrasound diagnosis on uterine sarcomas could be operated easily, economically and should be acted as the earliest way of diagnoses uterine sarcomas in elementary hospital. 　　[Key words] Uterine sarcomas; Ultrasound; Elementary hospital 　　 　　子宫肌瘤为常见且多发的妇科疾病,在基层医院的医师全面掌握其超声特点有利于其做出准确性较高的超声诊断,从而有效起到对子宫肌瘤初步筛查的作用。 　　1 临床资料 　　本组58例,年龄35~58岁,平均40.5岁,均经超声诊断为子宫肌瘤,均经手术切除。超声显示:子宫均有不同程度的增大,形态失常,子宫肌层或子宫黏膜下及浆膜下有团块回声,子宫内膜线可有偏移。 　　2 结果 　　2.1 病理诊断结果 　　术后病理诊断子宫肌瘤48例,子宫肌瘤合并囊性变2例,子宫肌瘤合并腺肌病2例,单纯腺肌病5例,纵隔子宫左侧宫腔不全流产,胚胎组织残留机化1例。 　　2.2 超声诊断结果 　　与病理结果符合和基本符合52例,???合率为89.7%;超声误诊6例,误诊率为10.3%。52例子宫肌瘤中,肌壁间肌瘤39例,占75.0%;黏膜下肌瘤6例,占11.5%;浆膜下肌瘤7例,占13.5%。 　　3 讨论 　　子宫肌瘤多发于子宫体部,按其生长部位与子宫各层的关系分为三型[1-2](肌壁间肌瘤、黏膜下肌瘤、浆膜下肌瘤),肌壁间肌瘤较多见,本组中有39例。超声可见子宫不规则增大,外形失常。肌壁间有单个或数个团块回声,团块周围有假包膜形成。轮廓因团块内回声增强,但后壁回声无明显衰减,团块较大时使子宫内膜线偏移。 　　黏膜下肌瘤较少见,本组有6例。超声可见宫腔内小团块回声,宫腔线分离,本组最小1例,团块1.5 cm×0.9 cm。此时子宫无明显增大,形态正常。有1例宫腔少许积血,其团块轮廓显示更为清