子宫腺肌症130例临床分析  

A clinical analysis of 130 cases of adenomyosis of uterus

作　　者：朱启江[1] 苏成芳[1] 

机构地区：[1]解放军第81医院妇产科,江苏南京210002

出　　处：《淮海医药》2010年第2期109-110,共2页Journal of Huaihai Medicine

摘　　要：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。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.

关 键 词：子宫腺肌症 外科手术 诊断 治疗 

分 类 号：R711.7[医药卫生—妇产科学]