子宫大部分切除术治疗子宫腺肌病的临床研究

Large Partial Excision of Uterine Body for Adenomyosis

目的探讨年轻的子宫腺肌病患者(≤40岁)保留子宫的手术方式。方法通过对78例子宫腺肌病病人进行荷包式缝合法子宫大部分切除子宫成形术(观察组),并选择同期因子宫腺肌病入院行全子宫切除术60例(对照组),比较术后患者对性生活评价。结果观察组术后性生活改善有效率为97.4%,对照组有效率为80.0%,差异有统计学意义(P<0.01)。结论荷包式缝合法子宫大部切除术后子宫成形术,手术方法简单,止血效果可靠,重新成形的子宫能够保留子宫部分内膜和子宫动脉上行支,痛经完全缓解或基本缓解,术后仍有少量月经,保留宫颈及阴道穹窿部,明显改善及提高夫妻双方性生活满意度。

Objective To investigate surgical methods of reserving partial uterus in young patients（ ≤40 years）with adenomyosis. Methods Seventy-eight patients of the study group received large partial excision of uterine body and metroplasty by purse-string suture, and 60 patients of the control group received total hysterectomy. Postoperative sexual life was evaluated in the two groups. Results There was a significant improvement of sexual life in the study group compared with the control group（97.4% versus 80.0% ,P〈0.01 ）. Conclusion The large partial excision of uterine body and metroplasty by purse-string suture is an effective and safe therapy for adenomyosis,which may completely or partly release dysmenorrhoea and significantly improve the satisfaction of sexual life due to reserving partial endometrium,the ascending branches of uterine artery, cervix and vaginal fornix.