子宫腺肌病保守手术治疗97例临床疗效分析  

Clinical efficacy of conservative surgery on adenomyosis in 97 patients

作　　者：刘婷婷[1] 郑明康[1] 

机构地区：[1]珠海市妇幼保健院妇一科,广东珠海519001

出　　处：《中国医药科学》2014年第19期20-23,共4页China Medicine And Pharmacy

基　　金：广东省珠海市科技计划项目(201411140004)

摘　　要：目的探讨在腹腔镜或传统开腹手术下子宫腺肌病病灶切除保守手术方法治疗子宫腺肌病的临床疗效。方法回顾性分析我院97例因子宫腺肌病行腹腔镜或传统开腹手术子宫腺肌病病灶切除保守手术方法治疗的患者临床资料。比较患者术前后痛经和月经量的改变、合并不孕症的患者术后妊娠改善及复发情况。结果子宫腺肌病合并子宫肌瘤和（或）子宫内膜异位症的患者较单纯子宫腺肌病患者痛经发生几率高,痛经程度较重;子宫腺肌病合并子宫内膜异位症的患者不孕症发生机率较高,子宫腺肌病合并子宫肌瘤的患者不孕症发生机率较低。术后30岁以上患者痛经缓解明显（痛经缓解率30-40岁组和〉40岁组分别为92.20%和81.80%）及月经量改善明显（月经量改变率30-40岁组和〉40岁组分别为45.16%和33.33%）,术后疗效较好。30岁以下患者症状改善稍差（痛经缓解率为53.80%,月经量改变率为5.88%）,患者术后复发率较低（19.58%）。手术对提高不孕症患者妊娠率有显著效果,且年龄越大,妊娠率提高越明显,呈上升趋势。结论子宫腺肌病病灶切除保守手术方法治疗子宫腺肌病,能较好改善患者症状,术后复发率较低,取得良好的临床疗效。Objective To investigate clinical efficacy of conservative surgery（laparoscopy or traditional laparotomy） in removing adenomyosis lesions. Methods Ninety-seven patients with adenomyosis undergoing conservative surgery（laparoscopy or traditional laparotomy） for excising adenomyosis lesions were retrospectively analyzed in this study.Dysmenorrheal,menstrual blood volume,gestation improvement in those complicated with infertility,and recurrence were compared between pre-and post-operation. Results Incidence of dysmenorrheal and dysmenorrheal severity were higher in the patients with adenomyosis complicated with myoma of uterus or endometriosis than those with only adenomyosis.Incidence of infertility was higher in the patients with adenomyosis complicated with endometriosis,and it was lower in those with adenomyosis complicated with myoma of uterus.In post-operative patients over 30 years old,dysmenorrheal was significantly alleviated（alleviation rate：92.20% in 30-40 year group vs.81.80% in〉 40 year group）,menstrual blood volume was significantly decreased（changing rate of the volume：45.16% in 30-40 year group vs.33.33% in 〉40 year group）,and the clinical efficacy was good.In the post-operative patients less than 30 years old,alleviation rate of dysmenorrheal was 53.80%,changing rate of menstrual blood volume was 5.88%,and the recurrence rate was 19.58%.Surgery had a significant effect in improving pregnant rate of infertility patients;the older the women,the more significantly the pregnant rate was increased. Conclusion Conservative surgery of adenomyosis lesions can effectively treat adenomyosis and alleviate the symptoms of the patients,who have a low recurrence rate after the surgery.This method achieves good clinical efficacy.

关 键 词：子宫腺肌病 保守手术 

分 类 号：R713[医药卫生—妇产科学]