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目的评估子宫马蹄形切除术的临床效果。方法对23例子宫腺肌病患者经腹子宫马蹄形切除术治疗,术后观察患者痛经程度、月经周期、贫血情况及性生活情况。结果术后1个月共有8例(占78%)症状消失或明显缓解,术后3个月有20例(占86%)症状消失,经量少,无潮热,性生活正常,术后6个月17例(占73%)症状消失,术后12月随访,20例症状消失,3例明显缓解(100%)。12例月经过多患者术后经量明显减少(P<0.05),月经周期和经期无明显改变(P>0.05),4例贫血患者术后3个月血红蛋白较术前明显升高(P<0.05),性生活满意。结论经腹子宫马蹄形切除术治疗子宫腺肌病疗效确切,手术安全,性生活不受影响,对于无生育要求、希望保留子宫、对生活质量要求高的患者,是一种较好的手术选择。
Objective To evaluate the clinical effect of uterine horseshoectomy. Methods Twenty - three cases of adenomyosis were treated by abdominal hysterectomy. The degree of dysmenorrhea, menstrual cycle, anemia and sexual life were observed after operation. Results A total of 8 cases (78%) disappeared or obviously relieved at 1 month after operation. Symptoms disappeared in 20 cases (86%) at 3 months after operation, with less volume, no hot flashes and normal sex life. Sixteen months, 17 cases (73%) disappeared. After 12 months of follow-up, 20 cases disappeared and 3 cases were relieved (100%). The postoperative menstrual flow volume was significantly decreased in 12 patients with menorrhagia (P <0.05), but no significant changes in menstrual cycle and menstruation (P> 0.05). The hemoglobin in 4 patients with anemia at 3 months postoperatively was significantly higher than that before operation (P < 0.05), sexual life satisfaction. Conclusions Transabdominal hysterectomy for the treatment of adenomyosis is effective and safe. It is not affected by sexual life. It is a better surgical choice for patients who have no requirement for reproduction and wish to keep the uterus, and have high quality of life.