子宫腺肌症患者子宫次全切除术后的危险性探讨

目的 :探讨子宫腺肌症患者子宫次全切除术后的危险性 ,为临床子宫腺肌症患者手术方式的选择提供指导。方法 :对子宫腺肌症患者行子宫次全切除术标本的子宫体下切缘进行常规病理组织学检查。结果 :子宫体下切缘子宫内膜异位病灶 (切缘阳性 )的发生率为 12 %。切缘阳性子宫腺肌症患者的子宫肌层最大厚度、临床症状以及是否合并子宫内膜异位症与切缘阴性的子宫腺肌症患者差异无显著性 (P >0 .0 5)。但切缘阳性子宫腺肌症患者的宫体纵形长度明显小于切缘阴性者 (P <0 .0 5)。结论 :子宫腺肌症患者的病程较长 ,病变弥漫、痛经明显且时间较长、合并子宫内膜异位症可能是子宫体下切缘阳性的高危因素 ,手术时切口过高是子宫体下切缘阳性的直接因素。子宫腺肌症患者如年龄较大同时存在高危因素 ,则应行全子宫切除术 ,如行子宫次全切除术 ,切口位置应尽量低 ,而且应对子宫体下切缘行病理组织学检查

The risk in the patients with adenomyosis after supracervical hysterectomy

Objective:To investigate the risk in the patients with adenomyosis after supracervical hysterectomy so as to guide the selection of operation on adenomyosis.Methods:Pathological examination were taken on the cutting edge of uterine specimens in the patients with adenomyosis after supracervical hysterectomy.Results:The incidence of ectopic endometrium appearing in the cutting edge of uterine specimens was 12%.There was no statistically difference between positive group and negative group about clinical symptoms, complicated endometriosis and the thickness of myometrium (P>0.05).Yet, there was significantly difference between positive group and negative group about the longitudinal length of uterus (P<0.05).Conclusions:The longer course of disease,diffuse foci,severe dysmenorrhea,complicated endometriosis may be the high risk factors for the positive incised edge of uterine specimens, and the longer stump is directly relative to the positive incised edge of uterine specimens.It is advisable to perform total hysterectomy for the aged patients with adenomyosis companied by the high risk factors and to make conventionally pathological examination on the incised edge of uterine specimens in the patients with adenomyosis after supracervical hysterectomy.