双瓣改良弥漫性子宫腺肌病病灶切除术的疗效观察

发布时间：2018-02-13 18:02

本文关键词： 子宫腺肌病痛经月经量过多保守性手术治疗　出处：《浙江大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的评价双瓣改良弥漫性子宫腺肌病病灶切除术治疗弥漫性子宫腺肌病的疗效及其安全性。方法收集2012年4月至2013年10月收住在浙江大学医学院附属妇产科医院行双瓣改良弥漫性病灶切除的44例子宫腺肌病患者的临床资料,术前影像学均诊断为弥漫性子宫腺肌病,术后经病理确诊为子宫腺肌病,对患者术前及术后痛经程度、月经量、血清CA125水平以及子宫大小进行比较。结果 44例患者平均年龄(38.11±5.03)岁,均已婚,其中26例合并有子宫内膜异位症,15例合并子宫肌瘤,既往有腹部手术史25例。所有患者均有不同程度的痛经及月经量增多病史,贫血24例(10.69±2.31g/L)。44例患者的平均孕次为(2.93±1.70)次,除3例未生育外,其余均已生育,在已生育的41患者中,2例有再生育要求。无论术后是否进行GnRHa治疗,其血清CA125水平、子宫大小、月经量和痛经程度均显著减少(P0.05)。术后3个月及以后各随访时间点的子宫体积均显著小于其相应术后1个月的子宫体积(P0.05)。但患者术后各随访时间点之间的月经量、血清CA125水平及痛经的严重程度比较,差异无统计学意义(P0.05)。术中与术后无严重并发症或后遗症发生。结论双瓣法子宫腺肌病病灶切除术可以明显缓解子宫腺肌病患者的症状并且是妇女希望保留子宫治疗弥漫性子宫腺肌病的一种方法。
[Abstract]:Purpose. Objective: to evaluate the efficacy and safety of modified double flap resection for diffuse adenomyosis. Method. The clinical data of 44 patients with adenomyosis received from April 2012 to October 2013 in the Department of Obstetrics and Gynecology affiliated to Zhejiang University Medical College were collected. All the patients were diagnosed as diffuse adenomyosis by preoperative imaging. The degree of dysmenorrhea, menstrual volume, serum CA125 level and uterine size were compared before and after operation. Results. The average age of 44 patients was 38.11 卤5.03 years old, all of them were married. Among them, 26 cases were complicated with endometriosis and 15 cases with uterine leiomyoma, 25 cases had a history of abdominal surgery. All the patients had different degrees of dysmenorrhea and increased menstrual volume. The average pregnancy times of 24 patients with anemia were 10.69 卤2.31 g / L ~ (.44). The average number of pregnancies was 2.93 卤1.70). All but 3 cases had already given birth. 2 of 41 patients who had already given birth had refertility requirements. Whether or not they were treated with GnRHa after operation, the serum CA125 level and uterine size were measured. The menstrual volume and the degree of dysmenorrhea decreased significantly (P 0.05). The uterine volume at 3 months after the operation and after the follow-up was significantly lower than that at 1 month postoperatively, but the menstrual volume between the follow-up time points of the patients was significantly lower than that of the patients at each follow-up time point. There was no significant difference in serum CA125 level and severity of dysmenorrhea. No serious complications or sequelae occurred during and after operation. Conclusion. Double flap resection of adenomyosis lesions can significantly relieve the symptoms of adenomyosis and is a method that women want to preserve the uterus for treatment of diffuse adenomyosis.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R713.4

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