子宫腺肌症130例临床分析

目的通过分析子宫腺肌症临床资料,以总结临床经验。方法回顾性分析2003年1月～2008年12月收治的130例子宫腺肌症患者临床资料。结果130例子宫腺肌症患者占同期妇科手术的14.7%,术前诊断为子宫腺肌症116例,诊断符合率89.23%。术前痛经者94例（72.31%）例,月经过多者6例,血CA125测定阳性率70.0%。术后随访1～5年,经腹子宫切除术后患者痛经缓解率100%,子宫腺肌瘤剥除术患者痛经缓解率95.3%。保守性手术配合药物治疗术后1年痛经缓解率94.4%,术后2年缓解率88.0%。有生育要求者8例,术后妊娠5例,足月妊娠2例,自然流产3例。结论子宫腺肌症治疗目前仍以手术为主,子宫切除可达根治目的。对年轻的患者,应制定个体化治疗方案。

A clinical analysis of 130 cases of adenomyosis of uterus

Objective To investigate clinical characteristics,diagnosis and treatment of adenomysis of uterus.Methods Clinical data of 130 patients with adenomysis of uterus confirmed by histo-pathology admitted in our hospital over a period from January 2003 to December 2008 were analyzed retrospectively.Results The 130 operations for adenomysis of uterus accounted for 14.7% of total gynecological operations in the same period.116 cases were diagnosed as adenomysis of uterus preoperatively with 89.23% diagnostic accordance rate.Among all patients 94（72.31%）cases had dysmenorrhea.The serum CA-125 was positive in 72.3% of patients measured.The relief rate of dysmenorrhea treated with hysterectomy was 100%,while that in women treated with adenomyosis resection of uterus was 95.3%.Dysmenorrhea was relieved in 94.4% of patients treated with conservative operation combined with hormonotherapy after one year and dysmenorrhea was relieved in 88.0% of the patients after two years.8 patients desired to preserve their fertility and 5 patients had pregnancy after operation,of which,2 women had term delivery and 3 women had spontaneous abortion.Conclusion Hysterectomy remains the dominant and radical treatment of adenomysis of uterus up to now.But for younger patients who desire to preserve their fertility,age,histo-pathological type of the lesion and family economic condition should be comprehensively analyzed to work out an individualized treatment scheme for the patients.