摘要
目的深部浸润型子宫内膜异位症(deeply infihmting endometriosis,DIE)是指病灶浸润侵袭至腹膜下深度>5mm的子宫内膜异位症,子宫腺肌病病灶分布广泛且边界不清,术后复发率高。本研究探讨U形病灶挖除手术治疗子宫腺肌病合并深部浸润型子宫内膜异位症时,能否在保留子宫的基础上切除子宫腺肌病病灶及周围DIE病灶。方法选取2011-05-31-2016-10-31在武汉商职医院妇产科接受手术治疗的55例伴有子宫腺肌病的DIE患者作为主要研究对象,根据患者要求在保留子宫的基础上,使用开腹手术+U形病灶挖除手术治疗。观察比较患者术前、术后3个月、术后6个月及12个月的视觉模拟评分(visual analogue scale,VAS),观察记录患者术前和术后12个月月经量减少情况、子宫体积大小和血清糖链抗原125(carbohydrate antigen 125,CA125)水平、妊娠分娩情况及并发症情况。结果 U形病灶挖除手术切除病灶并保留子宫的成功率100.00%;术后12个月的痛经VAS评分为(2.04±1.53)分,显著低于术前的(9.13±1.12)分;肛门坠胀VAS为(1.27±0.94)分,显著低于术前的(5.14±2.02)分;性交痛VAS评分为(1.38±0.65)分,显著低于术前的(3.87±1.84)分;术后12个月的月经量为(42.79±8.02)mL,明显少于术前(113.38±11.65)mL,t=8.882,P<0.001;CA125水平为(17.21±6.59)U/L,明显低于术前(95.43±17.94)U/L,t=15.219,P<0.001;术后12个月患者的子宫体积为(83.2±10.2)cm2,明显小于术前的(117.3±33.4)cm2,t=6.252,P<0.001;术后发生并发症3例(5.45%),对症治疗后均已痊愈。结论 U形病灶挖除术能够顺利挖除伴有子宫腺肌病的DIE患者的病灶部位,改善临床症状,减少并发症,同时还能有效保留患者子宫。
OBJECTIVE Deep infiltrating endometriosis(DIE)refers to endometriosis in which the infiltration of the lesion extends to the depth of the subperitoneum>5 mm.Adenomyosis is widely distributed with unclear boundaries and has a high recurrence rate.The purpose of this study is to investigate whether adenomyosis with deep infiltrating endometriosis can be resected on the basis of retaining uterus and surrounding DIE lesions in the treatment of adenomyosis combined with deep infiltrating endometriosis by excision of U-shaped lesions.METHODS A total of 55 DIE patients with adenomyosis were selected from May 31,2011 to October 31,2016,who underwent surgical treatment in Department of Gynecology and Obstetrics,Wuhan Commercial Hospital.According to the requirements of the patients,the surgical treatment of U-shaped lesion excision was used on the basis of the reservation of the uterus.The visual analogue score(VAS)was observed before surgery,3 months,6 months and 12 months after operation.The decrease of menstrual volume before surgery and 12 months after operation,the serum level of serum glucose carbohydrate antigen 125(CA125),pregnancy delivery and complications were observed.RESULTS The success rate of the U-type lesion was 100.00%when the lesion was resected and the uterus was preserved.The VAS score of dysmenorrhea at 12 months after operation was(2.04±1.53),which was significantly lower than that before operation(9.13±1.12).The VAS of anal distension was(1.27±0.94),which was significantly lower than that before operation(5.14±2.02).The VAS score of coitus pain was(1.38±0.65),which was significantly lower than that before operation(3.87±1.84).The menstrual volume at 12 months postoperatively was(42.79±8.02)ml,less than that before operation(113.38±11.65)ml,t=8.882,P<0.001.The serum glucose CA125 level was(17.21±6.59)U/L,which was significantly lower than that before operation(95.43±17.94)U/L,t=15.219,P<0.001.The uterine volume of patients at 12 months after operation was(83.2±10.2)cm2,less than that befo
作者
焦艳
龚利
JIAO Yan;GONG Li(Department of Obstetrics and Gynecology,Wuhan Commercial Hospital,Wuhan 430000,P.R.China)
出处
《社区医学杂志》
2019年第5期283-286,共4页
Journal Of Community Medicine
