摘要
目的:探讨45岁以上子宫内膜异位症(内异症)患者的临床特点和治疗。方法:回顾性分析我院手术治疗的288例45岁以上内异症患者的临床资料。结果:288例患者主要临床表现为盆腔包块(76.7%)、痛经(49.3%)、异常阴道流血(29.2%);术中发现合并其他妇科疾病者76.0%,其中妇科恶性肿瘤或癌前病变5.9%;根治性手术60.4%,保留卵巢功能的手术34.7%,保留生育功能的手术4.9%;术后73例(25.3%)行假孕治疗,18例(6.3%)行假绝经治疗;78例(27.1%)行激素替代治疗。随诊超过6个月者175例(60.8%),复发率2.9%(5/175)。结论:45岁以上内异症临床表现不典型,常与其他激素依赖性疾病并存,合并妇科恶性肿瘤及癌前病变的几率较高,建议行根治性手术,术后进行激素替代治疗不增加复发。
Objective： To investigate the clinical features and treatment of endometriosis in women aged 45 or older, Methods：All the clinical data of 288 cases of endometriosis in women aged 45 or older who received surgical treatment in our hospital from Jan lst,1995 to Dec 31st,2002 were reviewed retrospectively. Results：The patients＇ age ranged from 45 to 67. The main clinical presentation included pelvic mass （76.7%）, dysmenorrhea （49.3%） and abnormal vaginal bleeding （29.2%）,76% of the patients had other gynecological diseases such as leiomyoma （61.8%） ,adenomyoma （37,8%）,and gynecological malignant neoplasm or precancerous lesions （5,9%） that including three ovarian cancers, one ovarian borderline tumor, one uterine sarcoma, two endometrlal cancers and six atypical hyperplasia, and four CIN.60.4% of the patients underwent hysterectomy and bilateral salpingo-oophorectomy,34.7% underwent hysterectomy,4.9% received fertility-sparing surgical treatment. Progesterone was given to 73 cases （25.3%） after surgery and 18 cases （6.3%） received pseudo-menopause treatment,78 cases（27,1%） received hormone replacement therapy,245 patients （85,1%）were followed up, 175 of whom were followed for mere than six months,5 cases relapsed 6 to 36 months after surgery, the relapse rate was 2,9%. Conclusions： Women aged 45 years old or mere with endometriosis often have atypical presentations and other estrogen dependent diseases they also have high incidence of gynecological neoplasm and precancerous lesions. Total hysterectomy and bilateral salpingo-oophorectomy is recommended to these patients, Postoperative hormone replacement therapy does not seem to increase the incidence of relapse.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2006年第9期568-570,共3页
Journal of Practical Obstetrics and Gynecology
