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目的 探究子宫内膜息肉的临床特点、鉴别诊断要点、误诊原因及防范措施。方法 回顾分析2021年12月至2024年9月收治10例误诊为子宫内膜增生的子宫内膜息肉患者的临床资料。结果 本组患者以阴道不规则出血、月经紊乱3～4个月为主要表现，患者生命体征平稳，妇科查体未见异常。经阴道超声显示子宫内膜增厚不匀、宫腔内高回声占位伴点状或条状血流信号。初步诊为子宫内膜增生，予放置左炔诺孕酮宫内节育系统治疗后，效果不佳。后经宫腔镜检查及镜下活组织病理学检查确诊为子宫内膜息肉，误诊时间为2～3个月。本组患者确诊后均予宫腔镜电切术治疗。术后患者一般情况可，随访6个月患者病情好转，未复发。结论 女性子宫内膜息肉极易误诊为子宫内膜增生。临床医师应提高对子宫内膜息肉不典型图像的认识，结合患者病史，于适当时期对患者进行相关检查，必要时行宫腔镜检查及镜下活组织病理学检查，以降低误诊率。
Abstract：Objective To explore the clinical characteristics, key points of differential diagnosis, causes of misdiagnosis and preventive measures of endometrial polyps(EP). Methods The clinical data of 10 patients with EP misdiagnosed as endometrial hyperplasia(EH) admitted from December 2021 to September 2024 were retrospectively analyzed. Results The patients in this group mainly presented with irregular vaginal bleeding and menstrual disorders for 3 to 4 months. Their vital signs were stable, and no abnormalities were found during gynecological physical examinations. Transvaginal ultrasound shows uneven thickening of the endometrium, hyperechoic space-occupying lesions in the uterine cavity accompanied by punctate or strip-like blood flow signals. The initial diagnosis was EH. After being treated with the levonorgestrel intrauterine contraceptive system, the effect was not satisfactory. The patient was later diagnosed with EP through hysteroscopy and endoscopic biopsy. The misdiagnosis period was 2 to 3 months. All the patients in this group were treated with hysteroscopic electroresection after diagnosis. The general condition of the patients after the operation was good. At 6-month follow-up, the patient's condition improved and there was no recurrence. Conclusion EP in women are more likely to be misdiagnosed as EH. Clinicians should enhance their understanding of atypical images of EP, conduct relevant examinations for patients at appropriate time in combination with their medical history, and perform hysteroscopy and endoscopic biopsy when necessary to reduce the rate of misdiagnosis.
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基本信息:
DOI：
中图分类号:R711.74;R445.1
引用信息:
[1]刘晓燕,韩晓文,李桂平等.超声误诊为子宫内膜增生的子宫内膜息肉临床分析[J].临床误诊误治,2025,38(16):12-15.
基金信息:
2019年安徽省重点研究与开发计划项目(201904a07020032)