子宫腺肌病85例临床诊断和治疗探讨

Diagnosis and treatment of adenomyosis:85 cases

目的探讨子宫腺肌病的发病情况、临床表现、诊断和治疗。方法回顾性分析1996年1月～2003年12月我院收治的85例子宫腺肌病患者的临床资料。结果85例子宫腺肌病占我院同期妇科子宫切除的11.6%;前后4年相比近4年发病率明显升高(71.4%);术前痛经40例(47.1%);月经过多或紊乱49例(57.6%);术前诊断子宫腺肌病31例,诊断符合36.5%;B超诊断符合率17.6%;除2例行子宫腺肌瘤剔除术外,其余患者均行子宫切除术。结论近年来子宫腺肌病的发病率升高,术前易误诊,阴道B超和MRI可提高诊断率,治疗应个体化,目前仍以手术为主,药物和微创治疗提供了新的治疗途径。

Aim To study the incidence,clinical presentation,diagnosis and treatment of adenomyosis. Methods The clinical materials of 85 cases of adenomyosis were analyzed retrospectively. Results 85 cases of adenomyosis were 11.6% of total gynecological patients hysterectomy. 40/85(47.1%) cases had dysmenorrhea and 49/85(57.6%) had menorrhagia or menstrual disorders. 31 cases were diagnosed as adenomyosis preoperatively with 36.5% diagnostic accuracy. The diagnostic accuracy of ultrasound was 17.6%. All except two patients were treated with hysterectomy. Conclusions The incident rate of adenomyosis rose these years. TVS and MRI can increase the diagnostic accuracy. Hysterectomy remains the dominant treatment of adenomyosis up to now.