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<td colspan="2" bgcolor="FFE3F3"> 更新时间：2008-6-18 14:50:10 【字体：<a href="javascript:fontZoomA();" class="top_UserLogin">小</a> <a href="javascript:fontZoomB();" class="top_UserLogin">大</a>】</td>
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<p> 子宫肉瘤是一种罕见的高度恶性的女性生殖器肿瘤。组织学起源多是子宫肌层，亦可是肌层内结缔组织或子宫内膜的结缔组织。肉瘤可见于子宫各个部位，宫体部远较宫颈部常见约为15:1。 概述：</p>
<p> 子宫肉瘤是一种罕见的高度恶性的女性生殖器肿瘤。组织学起源多是子宫肌层，亦可是肌层内结缔组织或子宫内膜的结缔组织。肉瘤可见于子宫各个部位，宫体部远较宫颈部常见约为15:1。子宫肉瘤占子宫恶性肿瘤的2-5%，好发年龄为50岁左右，而宫颈葡萄状肉瘤多见于幼女。因早期无特异症状，故术前诊断率仅30-39%。</p>
<p> 症状体症：</p>
<p> 1.阴道异常出血：为最常见的症状，表现为绝经后阴道流血或月经异常。占65.5%-78.2%</p>
<p> 2.腹部包块：多见于子宫肌瘤肉瘤变者;包块迅速增大，若肉瘤向阴道内生长、常感阴道内有块物突出。子宫常增大，外形不规则，质实偏软。</p>
<p> 3.腹痛：亦是较常见的症状。由于肌瘤迅速生长令患者腹部胀痛或隐痛。</p>
<p> 4.阴道分泌物增多;可为浆液性、血性或白色，合并有感染时可为脓性、恶臭;</p>
<p> 5.若肿瘤较大，可压迫膀胱或直肠出现刺激症状，压迫静脉可出现下肢浮肿;</p>
<p> 6.晚期患者可有消瘦、贫血、发热、全身衰竭、盆腔包块浸润盆壁，固定不能活动</p>
<p> 诊断依据：</p>
<p> 1.子宫肉瘤无特异的症状和体征，临床表现与其他生殖道肿瘤有许多类似之处，且发病率低，易被忽视，欲提高术前诊断率;必须予以重视;</p>
<p> 2.绝经期前后或幼女不规则阴道流血伴子宫增大者;</p>
<p> 3.子宫肌瘤在经期迅速增大，尤其是绝经后子宫肌瘤患者，应考虑有肉瘤变的可能;</p>
<p> 4.既往曾接受过放射治疗的患者，子宫突然增大，伴异常阴道流血;</p>
<p> 5.宫颈赘生物、诊刮，或子宫切除标本经病理证实，(但诊刮阴性者不能排除)。</p>
<p> 治疗原则：</p>
<p> 1.手术治疗为主;</p>
<p> 2.放射治疗：子宫肉瘤对放疗敏感度较低，但对较晚期患者术前放疗可提高切除率，术后放疗对预防局部复发有一定作用;</p>
<p> 3.化学治疗。</p>
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