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目的 分析子宫腺肌症近年的发病情况、临床表现、诊断和治疗。方法 回顾性分析 2 0 0 0年 1月至 2 0 0 2年 12月三年间我院收治的 2 86例子宫腺肌症病人的临床资料。结果 2 86例子宫腺肌症病人 ,术前痛经 189例 (6 6 1% ) ,月经过多 132例 (46 1% ) ,术前诊断为子宫腺肌症 179例 ,诊断符合率 6 2 6 % ,B超诊断符合率 6 8 3% ,CA12 5测定阳性率 76 3%。除 4例行腺肌瘤剔除术外 ,其余均行子宫切除术。其中 4 6例曾用药物孕三烯酮 (内美通 )、米非司酮、雌孕激素类、三苯氧胺 +甲孕酮 (普维拉 )等治疗达 3个月以上 ,80 6 %痛经明显缓解 ,停药后 72 4 %的病人第 1个月经周期痛经复发。结论 子宫腺肌症目前治疗以手术为主 ,治疗子宫内膜异位症的常用药物对子宫腺肌症的痛经和月经过多均有效 ,但停药后痛经极易复发。
Objective To analyze the incidence of adenomyosis in recent years, clinical manifestations, diagnosis and treatment. Methods The clinical data of 286 patients with adenomyosis admitted to our hospital from January 2000 to December 2002 were retrospectively analyzed. Results A total of 286 cases of adenomyosis were diagnosed as 189 cases (66.1%) with premenopausal dysmenorrhea, 132 cases (46.1%) with premenstrual dysmenorrhea, 179 cases with adenomyosis diagnosed preoperatively, and the diagnostic coincidence rate was 6 2 6 %, B ultrasound diagnosis coincidence rate of 683%, CA12 5 determination of the positive rate of 76 3%. In addition to 4 cases of adenomyosis, the rest were underwent hysterectomy. Among them, 46 cases were treated with gestrinone (mesopram), mifepristone, estrogen and progesterone, tamoxifen plus medroxyprogesterone acetate for more than 3 months and 80 6% dysmenorrhea Alleviation, 72 4% of patients after discontinuation of the first menstrual cycle dysmenorrhea recurrence. Conclusion At present, the treatment of adenomyosis is mainly based on surgery. Commonly used drugs for the treatment of endometriosis are effective on dysmenorrhea and menorrhagia of adenomyosis, but dysmenorrhea can easily recur after stopping treatment.