国际妇产科学杂志

国际妇产科学杂志 ›› 2014, Vol. 41 ›› Issue (1): 73-76.

• 论著 • 上一篇    下一篇

107例子宫腺肌瘤局灶切除术的临床疗效分析

冯晓，戴志远，孙静，马骏，杨田如   

  1. 200040上海，同济大学附属第一妇婴保健院妇科（冯晓，戴志远，孙静）；南京医科大学附属苏州医院妇科（马骏，杨田如）
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2014-02-15 发布日期:2014-02-15
  • 通讯作者: 戴志远

Clinical Outcome of 107 Women Treated with Local Excision of Uterine Adenomyoma

FENG Xiao，DAI Zhi-yuan，SUN Jing，MA Jun，YANG Tian-ru   

  1. Department of Gynecology，Tongji University Affiliated First Maternity and Infant Hospital，Shanghai 200040，China（FENG Xiao，DAI Zhi-yuan，SUN Jing）；Department of Gynecology，Nanjing Medical University Affiliated Suzhou Hospital，Suzhou 215002，Jiangsu Province, China（MA Jun，YANG Tian-ru）
  • Received:1900-01-01 Revised:1900-01-01 Published:2014-02-15 Online:2014-02-15
  • Contact: DAI Zhi-yuan

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5662

被引次数

31

摘要： 目的：探讨子宫腺肌瘤局灶切除术的可行性及安全性。方法：回顾分析2005年10月-2012年3月南京医科大学附属苏州医院收治的有症状的107例子宫腺肌瘤患者治疗资料，所有患者均坚决要求保留子宫，均行子宫腺肌瘤局灶切除术，其中100例行经腹小切口子宫腺肌瘤局灶切除术，7例行腹腔镜下子宫腺肌瘤局灶切除术。比较分析患者手术时间、术中出血量、术后痛经及月经量的改善情况及子宫腺肌瘤复发情况。结果：术后6个月的随访中，接受随访的79例患者痛经症状均完全消失，43例月经过多患者月经量均恢复正常。术后48个月接受随访的28例患者中，有2例（7.1%）患者部分缓解，均予口服止痛药治疗；术后60个月接受随访的14例患者中，2例（14.3%）患者部分缓解，1例予口服止痛药治疗，1例予左炔诺孕酮宫内缓释系统（LUG-IUS，商品名曼月乐）治疗；2例（14.3%）患者痛经程度与术前级别相同，术后60个月行全子宫切除术。7例不孕患者中有1例术后3年妊娠，足月分娩；3例已育患者分别于术后2个月～1年妊娠，均行药物流产，另3例不孕患者术后至今未孕。结论：大多数有症状的子宫腺肌瘤患者可通过子宫腺肌瘤局灶切除术，达到完全缓解痛经及月经量过多的症状，疗效确切，可以成为替代全子宫切除术的成功手术方式，值得临床推广应用。

关键词: 子宫内膜异位症, 腹腔镜, 子宫切除术, 痛经, 月经过多, 随访研究

Abstract: Objective：To study the feasibility and safety of the local excision of uterine adenomyoma. Methods：To retrospective analyze 107 women with symptomatic uterine adenomyoma in Nanjing Medical University Affiliated Suzhou Hospital from October 2005 to March 2012，who refused to receive hysterectomy. All of them received the local excision of uterine adenomyoma，100 of them received the operation with routine abdominal small incision，and 7 received the operation with laparoscopy. Comparative analyze the operative time，intraoperative amount of bleeding，postoperative dysmenorrhea，menstrual quantity and uterine adenomyoma recurrence. Results：In 6 months follow-up，the dysmenorrhea symptom of 79 women were all disappeared completely，the menorrhagia symptom of 43 women were all disppeared. 48 months follow-up of 28 cases，the dysmenorrhea of 2 women（7.1%） were relieved ＜50% took oral painkiller；60 months follow-up of 14 cases，the dysmenorrhea of 2 women（14.3%） were relieved ＜50%. 1 case took oral painkiller，1 case was given Mirena IUD；dysmenorrhea degree of 2 women（14.3%） were the same level，60 months after the local excision，both of them got hysterectomy. In 7 infertility women，1 woman got pregnant 3 years after the operation andterm birth，the other 3 women who already had child，got pregnant two months to 1 year after the operation，all of them received drug abortion, the other 3 infertility women were still infertile. Conclusions：By analyzing the follow-up data，the majority women with symptomatic uterine adenomyoma could achieve the complete relief of dysmenorrhea and menorrhagia through the local excision of uterine adenomyoma. The local excision of uterine adenomyoma can gradually replace hysterectomy for uterine adenomyoma，and it is worth clinical application.

Key words: Endometriosis, Laparoscopes, Hysterectomy, Dysmenorrhea, Menorrhagia, Follow-up studies