2026 年第 3 期 第 21 卷

子宫腺肌瘤样息肉多次复发并大出血1例及文献分析

A case of recurrent adenomyomatous polyp of the uterus with massive hemorrhage and literature analysis

作者：刘梦颖席晓霄贺玉垠叶明珠孙信

英文作者：Liu Mengying Xi Xiaoxiao He Yuyin Ye Mingzhu Sun Xin

单位：中南大学湘雅三医院妇科，长沙410000

英文单位：Department of Gynecology the Third Xiangya Hospital of Central South University Changsha 410000 China

关键词：子宫腺肌瘤样息肉；异常子宫出血；宫腔粘连；宫腔镜手术

英文关键词：Uterineadenomyomatouspolyp;Abnormaluterinebleeding;Intrauterineadhesion;Hysteroscopicsurgery

• 摘要：

• 子宫腺肌瘤样息肉（AP），亦称息肉样腺肌瘤，是一种子宫内膜息肉亚型，其特征为息肉间质中混杂平滑肌纤维，治疗以手术切除为主。本文通过1例典型病例探讨AP的临床特点、诊疗策略及生育力保护。患者，35岁女性，以“经量增多1年，阴道流血17 d”为主诉首次就诊，宫腔镜结合病理检查明确为AP，后历经多次宫腔镜手术、高能量超声聚焦手术、药物治疗及子宫动脉栓塞术，最终发展为宫腔粘连严重影响生育功能。术后未定期随访，患者多次复发。文献综述表明，AP临床症状缺乏特异性，复发率高，需通过宫腔镜及病理检查明确。

• Uterine adenomyomatous polyp (AP), also known as polypoid adenomyoma, is a subtype of endometrial polyp characterized by the intermixture of smooth muscle fibers in the polyp stroma. Surgical resection is the mainstay of treatment. This article explores the clinical characteristics, diagnosis and treatment strategies, and fertility preservation of AP through a typical case. The patient was a 35-year-old female who first visited the hospital with the main complaints of "increased menstrual flow for 1 year and vaginal bleeding for 17 d". Hysteroscopy combined with pathological examination confirmed the diagnosis of AP. Later, she underwent multiple hysteroscopic surgeries, high-intensity focused ultrasound surgery, drug treatment, and uterine artery embolization, eventually developing severe intrauterine adhesions that significantly affected her fertility. The patient had no regular postoperative follow-up and experienced multiple recurrences. Literature review shows that AP lacks specific clinical symptoms and has a high recurrence rate, which must be confirmed by hysteroscopy and pathological examination.