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目的 探讨子宫内膜间质肉瘤的诊断、治疗方法及预后。方法 对 15例子宫内膜间质肉瘤临床资料进行回顾性分析。结果 确诊主要依靠病理结果 ,术前诊断性刮宫结合宫颈赘生物活检确诊率为 66 7%( 6/9) ;临床分期为Ⅰ期 11例 ,Ⅱ期 2例 ,Ⅲ期 1例 ,Ⅳ期 1例 ;行全子宫 (含次广泛 )及双侧附件切除术 8例 ,行全子宫切除或全子宫及单侧附件切除术 6例 ,行宫颈赘生物摘除术 1例 ;术后 11例全身化疗 ,3例辅以盆腔放疗 ;随诊 2例死亡 ,13例已存活 7～ 2 1年。结论 对此类患者 ,术前诊断性刮宫是必要的。疑有恶性应送冰冻病理检查 ;以采用全子宫加双侧附件切除术辅以化疗者疗效最好。
Objective To investigate the diagnosis, treatment and prognosis of endometrial stromal sarcoma. Methods The clinical data of 15 cases of endometrial stromal sarcoma were retrospectively analyzed. Results The diagnosis mainly depends on the pathological results. The diagnosis rate of preoperative diagnostic curettage combined with cervical neoplasm biopsy was 66.7% (6/9). The clinical stage was stage Ⅰ in 11 cases, stage Ⅱ in 2 cases, stage Ⅲ in 1 case, stage Ⅳ 1 Cases of total hysterectomy (including a wide range) and bilateral attachment resection in 8 cases, hysterectomy or uterine and unilateral attachment resection in 6 cases, 1 case of excision of cervical excision; 11 cases of postoperative systemic chemotherapy , 3 cases were supplemented with pelvic radiotherapy; 2 cases were followed up and 13 cases had survived for 7 ~ 21 years. Conclusion For such patients, preoperative diagnostic curettage is necessary. Suspected malignant should send frozen pathological examination; to adopt the whole hysterectomy with bilateral accessory resection supplemented by chemotherapy the best effect.