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目的:探讨子宫腺肌病的发病情况、临床诊断和治疗。方法:采用回顾性分析的方法,归纳统计了265例经手术治疗并经病理确诊的子宫腺肌病患者的临床资料并对所有患者进行随访。探讨其发病年龄、主要症状、体征、B超声像图特点、合并症、病理结果、手术治疗、术式选择情况。应用SPSS软件进行统计学分析。结果:31～40岁患者痛经发生率最高,随着年龄的增长,发生率逐渐下降;31～40岁患者慢性盆腔痛发生率最高;≤30岁患者不孕发生率最高;≤30岁患者月经改变发生率最高,随着年龄的增长,发生率逐渐下降。开腹手术组手术时间少于腹腔镜手术组,腹腔镜手术组少于阴式手术组,但三者差异无统计学意义;腹腔镜手术组术中出血量明显少于开腹手术组和阴式手术组,开腹手术组和阴式手术组比较差异无统计学意义;腹腔镜手术组和阴式手术组术后住院天数明显少于开腹手术组,腹腔镜手术组和阴式手术组比较差异无统计学意义。265例患者中,术前正确诊断率为80.1%,误诊和漏诊率为19.9%。结论:子宫腺肌病的发病年龄集中在30～50岁,发病年龄向后推迟;痛经、月经异常或不规则阴道流血、慢性盆腔痛及不孕是子宫腺肌病的主要症状;年龄与病变程度是决定子宫腺肌病手术术式的关键,子宫切除术最终可以达到根治的目的,腹腔镜手术及阴式手术损伤小、恢复快、住院时间短的优势正逐步为患者所接受。
Objective: To investigate the incidence of adenomyosis, clinical diagnosis and treatment. Methods: A retrospective analysis of the method of 265 cases of surgical treatment of pathologically confirmed adenomyosis in patients with clinical data and all patients were followed up. To discuss its age of onset, the main symptoms, signs, B ultrasound features, complications, pathological results, surgical treatment, surgical options. Apply SPSS software for statistical analysis. Results: The incidence of dysmenorrhea was the highest in patients aged 31-40 years. The incidence of dysmenorrhea was gradually decreased with the increase of age. The incidence of chronic pelvic pain was the highest in patients aged 31-40 years. The incidence of infertility was the highest in patients aged ≤30 years. The highest rate of change, with age, the incidence decreased. The laparoscopic surgery group had less operation time than laparoscopic surgery group and laparoscopic surgery group, but the difference was not statistically significant Laparoscopic surgery group and vaginal surgery group was significantly less postoperative hospital stay than laparotomy group, laparoscopic surgery group and vaginal surgery group The difference was not statistically significant. Of the 265 patients, the correct preoperative diagnosis rate was 80.1%, misdiagnosis and missed diagnosis rate was 19.9%. Conclusions: The age of onset of adenomyosis is 30 to 50 years old and the age of onset is postponed. Dysmenorrhea, abnormal menstruation or irregular vaginal bleeding, chronic pelvic pain and infertility are the main symptoms of adenomyosis. Age and disease Degree is the key to determine the surgical method of adenomyosis, hysterectomy can eventually achieve the purpose of cure, laparoscopic surgery and vaginal surgery injury is small, fast recovery, shorter hospital stay advantages are gradually accepted by patients.