局灶切除术治疗子宫腺肌病临床疗效分析

Analysis on the Therapeutic Effect of Local Resection for the Treatment of Adenomyosis

目的探讨局部病灶切除术治疗子宫腺肌病的临床效果。方法选取2010年3月至2014年7月在麻城市人民医院治疗的子宫腺肌病患者120例,采用随机数字表法分为两组,各60例。观察组接受局部病灶切除术治疗,对照组接受子宫动脉栓塞术治疗。对比术前、术后3个月、术后6个月及术后12个月两组患者的痛经情况、子宫体积变化、血红蛋白水平及糖类抗原(CA)125水平。结果术后两组患者的痛经情况得到有效缓解,术后各时段两组患者的痛经缓解情况对比,差异均无统计学意义(P>0.05)。两组术后3、6、12个月子宫体积均较治疗前呈下降趋势[观察组(96±10)cm3、(83±10)cm3、(78±8)cm3比(229±21)cm3;对照组(165±14)cm3、(162±13)cm3、(156±12)cm3比(229±21)cm3],观察组下降速度更快,两组在组间、不同时点间、组间·不同时点间交互作用比较差异有统计学意义(P<0.05)。两组术后3、6、12个月的血红蛋白水平较治疗前明显提升[观察组(103±23)g/L、(114±21)g/L、(124±20)g/L比(78±17)g/L;对照组(98±22)g/L、(116±21)g/L、(121±19)g/L比(76±16)g/L],不同时点间差异有统计学意义(P<0.05)。两组术后3、6、12个月CA125水平较治疗前呈下降趋势[观察组(43±8)k U/L、(37±4)k U/L、(34±5)k U/L比(86±17)k U/L;对照组(44±7)k U/L、(38±4)k U/L、(33±6)k U/L比(91±18)k U/L],不同时点间差异有统计学意义(P<0.05)。结论局部病灶切除术同子宫动脉栓塞术一样,均能够有效改善患者临床症状,近期疗效明确,可以将其作为替代全子宫切除术的手术方式在临床上积极推广。

Objective To explore the clinical effect of local resection for the treatment of adenomyosis.Methods Total of 120 patients of adenomyosis in Macheng City People＇s Hospital from March 2010 to July2014 weredivided into two groups according to the random number table method,60 patients each. The observation group received local lesion resection treatment,and the control group received uterine artery embolization treatment. Before surgery and 3 months,6 months and 12 months after operation,the dysmenorrhea,uterine volume changes,hemoglobin level and carbohydrate antigen（ CA） 125 level of the two groups were compared. Results After the operation,dysmenorrhea of both groups was effectively relieved,the differences during different postoperative periods were not significantly different（ P〉0. 05）. The 3,6,12 months postoperative uterine volume of both groups were decreased than before treatment [observation group：（ 96 ±10） cm3,（ 83 ± 10） cm3,（ 78 ± 8） cm3vs（ 229 ± 21） cm3; control group：（ 165 ± 14） cm3,（ 162 ±13） cm3,（ 156 ± 12） cm3vs（ 229 ± 21） cm3],the observation group decreased faster,the differences between groups,between different time points,groups time points were statistically significant（ P〈0. 05）.The 3,6,12 months postoperative hemoglobin levels of th two groups were significantly improved from before treatment[observation group：（ 103 ± 23） g / L,（ 114 ± 21） g / L,（ 124 ± 20） g / L vs（ 78 ± 17） g / L; control group：（ 98 ± 22） g / L,（ 116 ± 21） g / L,（ 121 ± 19） g / L vs（ 76 ± 16） g / L],the differences were statistically significant（ P〈0. 05）. 3,6,12 months postoperative CA125 levels of the two groups were decreased than before treatment[observation group：（ 43 ± 8） k U / L,（ 37 ± 4） k U / L,（ 34 ± 5） k U / L vs（ 86 ±17） k U / L; control group：（ 44 ± 7） k U / L,（ 38 ± 4） k U / L,（ 33 ± 6） k U / L vs（ 91 ± 18） k U / L],the differences were statistically significant（ P〈0. 05）. Conclusion Local resection is the same as the uterine artery embolization in improving the clinical symptoms of the patients with affirmative short-term effect. It can be promoted actively in clinical as an alternative to total hysterectomy..