围绝经期女性子宫肌瘤转归影响因素及生活质量分析  

Analysis of the influencing factors and quality of life of perimenopausal women with uterine fibroids

作　　者：战海峰 郭延荣[2] 黄臻 李丹[1] 魏雅丽 杨敏 ZHAN Hai-feng;GUO Yan-rong;HUANG Zhen;LI Dan;WEI Ya-li;YANG Min(Shanghai Jing’an District Central Hospital,Shanghai 200040,China;Obstetrics and Gynecology Hospital,Fudan University,Shanghai 200011,China;West Nanjing Road Community Hospital,Jing’an District,Shanghai 200030,China)

机构地区：[1]上海市静安区中心医院,上海200040 [2]复旦大学附属妇产科医院,上海200011 [3]上海市静安区南京西路街道社区卫生服务中心,上海200030

出　　处：《中国临床医学》2021年第6期999-1004,共6页Chinese Journal of Clinical Medicine

基　　金：上海市静安区卫生健康委员会医学科研课题(2018MS03).

摘　　要：目的:回顾性研究影响围绝经期子宫肌瘤患者转归的因素,分析手术治疗组及非手术治疗组生存质量上的差异,为此类患者治疗方案的选择提供依据。方法:随机选取在2012年—2021年于上海市静安区中心医院及复旦大学附属妇产医院就诊的围绝经期最大肌瘤直径在2~5 cm的女性中符合标准的320例患者。患者均完成调查问卷,按最后一次随访结局分为手术干预组(n=107)和非手术干预组(n=213)。采用问卷形式录入病史资料,采用围绝经期Greene量表评估生活质量。结果:影响肌瘤患者选择治疗方式的因素包括年龄、现住址、户籍、体质量指数(BMI)、痛经程度、分娩方式、有无基础性疾病、肌瘤年限、肌瘤个数、有无并发症、绝经年龄、肌瘤部位、肌瘤大小等共计13项。手术组与非手术组在心理症状、躯体症状及血管收缩性症状方面满意度差异无统计学意义,非手术组在性生活方面的满意度高于手术组(P=0.005)。结论:围绝经期子宫肌瘤患者是否选择手术治疗受多种因素影响,除性生活满意度外,两种治疗方式对生活质量影响差异不明显,应根据患者病史特点个性化选择治疗方案。Objective: To retrospectively study the factors affecting the outcome of perimenopausal patients with uterine fibroids, and to analyze the differences in the quality of life between the surgical treatment group and the non-surgical treatment group, so as to provide the basis for the selection of treatment options for such patients. Methods: 320 female patients who met the criteria with the largest perimenopausal fibroids diameter of 2-5 cm in the Jing’an District Central Hospital and Fudan University Obstetrics and Gynecology Hospital from 2012 to 2021 were randomly selected. All patients completed the questionnaire and were divided into surgical intervention group(n=107) and non-surgical intervention group(n=213) according to the outcome of the last follow-up. Medical history data were entered in the form of questionnaires, and the perimenopausal Greene scale was used to assess the quality of life. Results: The factors affecting the selection of treatment methods for patients with fibroids included age, current address, household registration, body mass index(BMI), degree of dysmenorrhea, mode of delivery, with or without underlying diseases, years of fibroids, number of fibroids, with or without complications, age at menopause, location of fibroids, and size of fibroids. There was no significant difference in the satisfaction rate of psychological symptoms, somatic symptoms and vasoconstrictive symptoms, and the satisfaction rate of sexual life in the non-surgical group was higher than that in the surgical group(P=0.005). Conclusions: The choice of surgical treatment for perimenopausal patients with uterine leiomyomas is affected by a variety of factors.There is no significant difference in the impact of quality of life between the two treatment modalities except sexual satisfaction.The treatment plan should be individualized according to the characteristics of patients’ medical history.

关 键 词：围绝经期 子宫肌瘤 疾病转归 生活质量 

分 类 号：R737.33[医药卫生—肿瘤]