弹射式空芯针活检用于子宫内膜异位症不孕症合并腺肌病的临床分析

摘要

目的：探讨子宫内膜异位症不孕症患者中合并子宫腺肌病的发病率及子宫肌层穿刺活检的临床价值。方法178例术前B超未提示异常的盆腔子宫内膜异位症期患者；8例术前B超提示子宫腺肌病的盆腔子宫内膜异位症患者，在腹腔镜下利用快速活检枪进行子宫后壁肌层6点穿刺并送病理检查，术后均放置腹腔引流管。结果（1）186例患者均穿刺成功，穿刺术中术后未见严重并发症；（2）病理检查发现178例术前检查未提示子宫腺肌病的子宫内膜异位症患者，23例（12.9%）合并子宫腺肌病；8例术前检查提示子宫腺肌病者有6例（75%）确诊。结论（1）术前检查无异常提示的子宫内膜异位症患者中有部分患者合并子宫腺肌病；（2）利用快速活检枪进行子宫肌层穿刺活检安全可行，并发症少。%Objective To discuss the morbidity of the adenomyosis among patients with endometriosis and the clinical value of biopsy examination of the uterus myometrium puncture.Methods178 patients with endometriosis whose preoperative B-ultrasound detect no abnormality and 8 patients with endometriosis whose preoperative B-ultrasound detect adenomyosis, we choose 6 points in the uterus myometrium to puncture to all of them by the biopsy gun, the specimens were studied with pathological examinations. Postoperative all of the patients placed the peritoneal drainage tubes.Results (1) Punctures of 186 patients are all successful. And no serious complications are found during an operation or after. (2) Pathological examinations show that 23 (12.9%) of 178 patients with endometriosis whose B-ultrasound detect no abnormality exist adenomyosis actually. 6 (75%) cases of 8 patients whose preoperative B-ultrasound detect adenomyosis do have adenomyosis. Conclusion (1) Part of patients with endometriosis whose preoperative inspections ifnd no abnormalities actually combine the adenomyosis. (2) Use the biopsy gun to conduct the puncture of myometrium is safe and feasible, and there are few complications when using the biopsy gun.