围绝经期症状性子宫肌瘤患者行子宫肌瘤剔除术的可行性

Feasibility of myomectomy in perimenopausal women with symptomatic uterine myoma

目的分析围绝经期子宫肌瘤患者子宫肌瘤剔除术后症状缓解及肌瘤复发率，以评价子宫肌瘤剔除术的可行性。方法收集2007年1月～2013年8月在广西横县人民医院行子宫肌瘤剔除术后定期随访、随访资料完整的190例围绝经期症状性子宫肌瘤患者资料，回顾性分析术后的症状缓解率、复发肌瘤大小、复发时间、单发肌瘤与多发肌瘤术后复发情况、复发后相关治疗措施。结果围绝经期症状性子宫肌瘤患者术后症状完全缓解率为90．00％，部分缓解率为4．21％，未缓解率为5．79％。肌瘤剔除术后复发率为22．63％，复发以小肌瘤（〈2cm）为主，再次手术率为2．33％。单发肌瘤与多发肌瘤术后复发率比较差异有统计学意义（P〈O．05）。结论围绝经期症状性子宫肌瘤患者术后症状缓解率高，复发以小肌瘤为主，复发患者以随访观察为主，药物治疗为辅．再次手术率低，其手术方式可首选子宫肌瘤剔除术。

Objective To analyze the symptom remission and recurrence rate after myomectomy in perimenopausal pa- tients with uterine fibroids and in order to evaluate the feasibility of myomectomy.nethods The data of 190 cases peri- menopausal patients with symptomatic uterine myoma who were regularly followed-up after myomectomy in Guangxi Hengxian people＇s Hospital from January 2007 to August 2013 were collected.The postoperative symptom remission rate,relapsed fibroid size,recurrence time,single myoma and multiple myoma postoperative recurrence and the related treatment measures after recurrence were analyzed.Results Perimenopausal patients with symptomatic uterine myoma postoperative remission rate was 90.00%,partial remission rate was 4.21%,no remission rate was 5.79%.Myomectomy re- currence rate was 22.63%,recurrence mainly occurred in small myoma（〈2 cm）,reoperation rate was 2.33%.Single myoma and multiple myoma in postoperative recurrence rate was compared,with statistical difference （P〈0.05）.Conclusion The postoperative symptom relief rate of perimenopausal patients with symptomatic uterine myoma is high,and the recur- rence occurs mainly in small myoma.Recurrence patients are mainly observed and followed-up,supplemented with drug therapy,the reoperation rate is low.Myomectomy can be the preferred operation method in perimenopausal patients with symptomatic uterine myoma.