| Objective:To summary and analysis the incidence of clinical features,the treatment methods and the characteristics of postoperative pathologyof endometrial adenomatous polyps,and to discuss the high risk factors of the disease and carcinogenesisof endometrial adenomatous polyps.finally,to providea clinical basis forThe early detection risk factors,standardization and individualized diagnosis and treatment and maintenance of reproductive health of endometrial adenomatous polyps.Method:From January 2014 to December 2017,3398 cases of endometrial polyps were diagnosed as endometrial polyps,119 cases were PA among them.In this paper,the incidence,clinical features and treatment of 119 PA patients were compared with those of the general endometrium polyps.Results:1、The age of PA patients was 22~81 years old(average 48.8 + 10.5).The age of APA patients was 22 ~ 67 years old(average 43.6 + 12.1).The height of the occurrence of PA was 40 ~ 50 years.The high incidence stage of APA was fertile period,and the high incidence stage of TPA fertile period perimenopausal period.2、The average number of pregnancy,births and abortions in patients with PA were higher than those in patients with normal endometrial polyps,P<0.05.The average number of gestational times,births,and abortions in patients with TPA were higher than in those with APA,P<0.05.The proportion of patients with no birth history in APA was significantly higher than that in patients with TPA,P<0.05.The proportion of TPA with infertility is much lower than that of APA with infertility,P<0.05.3、The most common clinical feature of PA is irregular vaginal bleeding,followed by physical examination.Most of the patients with APA had no obvious symptoms.The main findings were physical examinations.Most TPA patients had irregular vaginal bleeding as the most common clinical symptom.PA.4、In the ultrasound examination,the detection rate of mass with clear borders of PA was higher than that of general endometrial polyps,P<0.05;The detection rate of blood flow signals was seen in PA hgher than the average endometrial polyp,P <0.05.PA lesions were larger than the general endometrial polyp lesions,P <0.05.5、The proportion of all pathological types in 3398 patients was 94.82 of endometrial polyps,3.18% of TPA,0.32% of APA,and 0.35% of endometrial polyps with simple hyperplasia.There were 1.12% of endometrial polyps with complicated hyperplasia,and.21% of endometrial polyps with atypical hyperplasia.6、The incidence of PA combined with atypical hyperplasia or endometrial cancer was higher than that of endometrial polyps,P<0.05.The incidence of APA combined with endometrial precancerous lesion or endometrial cancer was higher than that of TPA,P<0.05.7、Among the PA patients,there were 2.52% with a history of breast cancer,0.84% with a history of tamoxifen administration,15.96% with hypertension,and 4.20% with diabetes,and 2.52% with obese.8、The incidence of anemia and the degree of anemia in PA patients were higher than those in patients with endometrial polyps,P<0.05.Conclusion:1、Compared with normal endometrial polyps,PA is more prone to anemia and abnormal changes in ultrasound examination.TPA always occurs in preprocreated perimenopausal women.APA mostly occurs in fertile period with infertility.2、PA is more likely to be associated with endometrial precancerous lesion or endometrial cancer than normal endometrial polyps.At the same time,the incidence of endometrial atypical hyperplasia or endometrial cancer in PA is higher than that of normal endometrial polyps.3、Hysteroscopic resection of the lesions is the preferred treatment for PA.For those young APA patients who require fertility preservation,the four-step hysteroscopic technique is feasible.For APA patients who do not have fertility requirements,the hysterectomy should be selected. |
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