子宫腺肌病306例临床分析

Clinical analysis of 306 cases of uterine adenomyosis

目的 探讨子宫腺肌病的病因及诊断方法 ,以提高临床诊断正确率。方法 对 2 0 0 1年 1月至2 0 0 3年 6月在我院经妇科手术后病理证实为子宫腺肌病 30 6例的临床资料进行回顾性分析。结果 多见于31～ 5 0岁经产妇 ,占 86 3%。最常见的临床表现是月经异常 (包括合并痛经 )。 6 0 8% (186 /30 6 )合并子宫肌瘤 ,术前临床诊断符合率仅有 18 6 % (5 7/30 6 ) ,B超诊断符合率仅有 31 4 % ,临床误诊高达 78 1%。结论 子宫腺肌病发病是内分泌失调、高雌激素刺激、损伤和炎症等综合因素作用的结果。临床应提高对本病的重视 ,结合病史、临床症状和必要的盆腔检查 ,进行综合判断 ,以减少误诊。

Objective To explore the aetiology and diagnosis methods of uterine adenomyosis so as to elevate the accuracy of clinical diagnosis.Methods The clinical data of 306 patients admitted to our hospital from January 2001 to June 2003 were analyzed for uterine adenomyosis with pathologic diagnosis after uterectomy.Results The majority of patients were 31 to 50 years of the multiparous women's ages(86.3%).The most common symptoms and signs were menstrual abnormity(including menorrhalgia).Among the 306 cases there were 181 cases(60.8%) complicated with myoma.Before operation,accuracy in diagnosis was only 18.6% by physical check up,the clinical miss dignosis were up to 78.1%.Conclusion The disease should be associated with stimulation by high level of estrogen and intrauterine opertion and chronic cervicitis.Diagnosis should be made based on combination with hostory,clinical features and pelvic cavity examination.It is critical to be fully aware of the characteristics of this disease so as to minimize misdiagnosis.