中国计划生育和妇产科
中國計劃生育和婦產科
중국계화생육화부산과
CHINESE JOURNAL OF FAMILY PLANNING & GYNECOTOKOLOGY
2014年
7期
49-52
,共4页
子宫肌瘤%临床特点%手术方式
子宮肌瘤%臨床特點%手術方式
자궁기류%림상특점%수술방식
uterine leiomyoma%clinical characteristic%operative manner
目的：探讨子宫肌瘤患者临床特点、肌瘤生物学特征与手术方式的关系，为子宫肌瘤的个性化诊治提供参考。方法选择江苏盛泽医院2009年1月至2013年11月收治的子宫肌瘤行手术治疗的268例患者临床资料，对子宫肌瘤患者临床特点、肌瘤生长方式、手术方式的选择进行回顾性分析。结果268例子宫肌瘤术后标本直径0.8~19 cm，单发肌瘤107例（39.93%），多发肌瘤161例（60.07%）；肌壁间肌瘤210例（78.36%），浆膜下与黏膜下肌瘤53例（19.78%），子宫颈肌瘤5例（1.87%）。术后病理结果有58例肌瘤发生部分变性，变性类型包括富于细胞型子宫肌瘤、子宫肌瘤伴红色变性、玻璃样变性、囊性变、黏液样变、脂肪变、钙化。72例患者行阴式手术治疗，其中21例子宫肌瘤切除术，31例子宫全切除术，20例子宫次全切除术；196例行经腹手术治疗，其中79例经腹子宫肌瘤切除术，87例全子宫切除术（同时行双侧附件切除21例），30例次全子宫切除术。结论肌瘤切除术适合于年轻、尚未生育需保留生育功能、患者要求保留子宫者；如患者无生育要求、肌瘤较大或较多，或疑有恶变者应行子宫切除术；选择一种最适合患者的术式是确保手术成功的关键。
目的：探討子宮肌瘤患者臨床特點、肌瘤生物學特徵與手術方式的關繫，為子宮肌瘤的箇性化診治提供參攷。方法選擇江囌盛澤醫院2009年1月至2013年11月收治的子宮肌瘤行手術治療的268例患者臨床資料，對子宮肌瘤患者臨床特點、肌瘤生長方式、手術方式的選擇進行迴顧性分析。結果268例子宮肌瘤術後標本直徑0.8~19 cm，單髮肌瘤107例（39.93%），多髮肌瘤161例（60.07%）；肌壁間肌瘤210例（78.36%），漿膜下與黏膜下肌瘤53例（19.78%），子宮頸肌瘤5例（1.87%）。術後病理結果有58例肌瘤髮生部分變性，變性類型包括富于細胞型子宮肌瘤、子宮肌瘤伴紅色變性、玻璃樣變性、囊性變、黏液樣變、脂肪變、鈣化。72例患者行陰式手術治療，其中21例子宮肌瘤切除術，31例子宮全切除術，20例子宮次全切除術；196例行經腹手術治療，其中79例經腹子宮肌瘤切除術，87例全子宮切除術（同時行雙側附件切除21例），30例次全子宮切除術。結論肌瘤切除術適閤于年輕、尚未生育需保留生育功能、患者要求保留子宮者；如患者無生育要求、肌瘤較大或較多，或疑有噁變者應行子宮切除術；選擇一種最適閤患者的術式是確保手術成功的關鍵。
목적：탐토자궁기류환자림상특점、기류생물학특정여수술방식적관계，위자궁기류적개성화진치제공삼고。방법선택강소성택의원2009년1월지2013년11월수치적자궁기류행수술치료적268례환자림상자료，대자궁기류환자림상특점、기류생장방식、수술방식적선택진행회고성분석。결과268례자궁기류술후표본직경0.8~19 cm，단발기류107례（39.93%），다발기류161례（60.07%）；기벽간기류210례（78.36%），장막하여점막하기류53례（19.78%），자궁경기류5례（1.87%）。술후병리결과유58례기류발생부분변성，변성류형포괄부우세포형자궁기류、자궁기류반홍색변성、파리양변성、낭성변、점액양변、지방변、개화。72례환자행음식수술치료，기중21례자궁기류절제술，31례자궁전절제술，20례자궁차전절제술；196례행경복수술치료，기중79례경복자궁기류절제술，87례전자궁절제술（동시행쌍측부건절제21례），30례차전자궁절제술。결론기류절제술괄합우년경、상미생육수보류생육공능、환자요구보류자궁자；여환자무생육요구、기류교대혹교다，혹의유악변자응행자궁절제술；선택일충최괄합환자적술식시학보수술성공적관건。
Objective To analyze the correlation between operative manner and the clinical characteristics, biological features of the uterine leiomyomas, to guide the individualized diagnosis and treatment of uterine leiomyomas. Methods Drom January 2009 to November 2013,the clinical data of 268 patients with uterine leiomyoma in Shengze hospital were collected. The patients ’ clinical characteristics,growth manners of uterine leiomyomas,the choice of operative manner were retrospectively analyzed. Results The diameter of uterine leiomyomas specimens of the 268 patients ranged from 0. 8 cm to 19 cm. 107 patients were of single tumor (39. 93%),and 161 patients were of multiple tumors(60. 07%). 210 cases were intramural myoma(78. 36%),53 cases were subserosal and submucous myoma ( 19. 78%),5 cases were cervical myoma ( 1. 87%). The postoperative pathological results showed that 58 cases of leiomyomas had degenerated. The types of degeneration included cellular leiomyoma of the uterus,red degeneration,hyaline degeneration,cystic degeneration,mucoid degeneration,fatty degeneration,and calcification. 72 patients received transvaginal operation,including 21 cases of uterine leiomyomas resection,31 cases of total hysterectomy,20 cases of subtotal hysterectomy. 196 patients received transabdominal operation,including 79 cases of uterine leiomyomas,87 cases of total hysterectomy(21 cases received bilateral accessory resection at the same time ) and 30 cases of subtotal hysterectomy resection. Conclusion Myomectomy was suitable for young,childless and with fertility requirements patients,or the patients with request of retaining uterus. Hysterectomy was suitable for the patients with large or multiple fibroids and without fertility requirements,or the cases whose leiomyomas being suspected malignant. To select suitable operative manner for patient was the key to ensure the success of operation.
