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目的:探讨子宫后壁和(或)前壁梭形切除术治疗子宫腺肌病的临床疗效。方法:选择166例月经过多伴痛经的患者,曼月乐组60例患者单纯采用曼月乐环治疗,手术组66例患者单纯采用子宫后壁和(或)前壁梭形切除术治疗,手术+曼月乐环组40例患者行子宫后壁和(或)前壁梭形切除术后6个月再予以曼月乐环治疗,观察3组患者在治疗后6个月及24个月月经量和痛经症状。结果:①各组治疗后月经量的改变:治疗后6个月,曼月乐组有效率为71.67%,手术组有效率为86.36%,两组有效率差异无统计学意义(P=0.108);治疗后24个月,曼月乐组有效率为63.33%,手术组有效率为89.39%,手术+曼月乐环组有效率为97.50%,各组间有效率差异有统计学意义(P=0.000)。②各组治疗后痛经程度的改变:治疗后6个月,曼月乐组有效率为55.00%,手术组有效率为78.79%,各组间有效率有统计学差异(P=0.004);治疗后24个月,曼月乐组有效率为51.67%,手术组有效率为71.21%,手术+曼月乐环组有效率为95.00%,各组间有效率比较有统计学差异(P=0.000)。结论:采用子宫后壁和(或)前壁梭形切除术治疗子宫腺肌病疗效满意。
Objective: To explore the clinical efficacy of the posterior wall and / or anterior fusiform excision in the treatment of adenomyosis. Methods: Sixty-six patients with menorrhagia who had dysmenorrhea were selected. Sixty-six patients in Mirena group were treated with Mirena ring alone. Sixty-six patients in the operation group were treated by fusiform excision of the posterior wall of the uterus and / or anterior wall, Forty patients with operation + Mirena group were treated with Mirena ring 6 months after the posterior wall of the uterus and / or anterior wall. Six months and 24 months after treatment Menstrual volume and dysmenorrhea symptoms. Results: ①The changes of menstrual flow in each group after treatment: the effective rate was 71.67% in Mirena group and 86.36% in operation group at 6 months after treatment, and there was no significant difference between the two groups (P = 0.108) ; 24 months after treatment, the effective rate was 63.33% in Mirena group, the effective rate was 89.39% in operation group and 97.50% in Mirena group, the difference was statistically significant (P = 0.000). (2) The degree of dysmenorrhea changed after treatment in each group: the effective rate was 55.00% in Mirena group and 78.79% in Mirena group after 6 months of treatment, with significant difference between the groups (P = 0.004); treatment After 24 months, the effective rate was 51.67% in Mirena group, 71.21% in operation group and 95.00% in Mirena group, with significant difference (P = 0.000 ). Conclusion: Fetal adenomyosis treated by posterior wall of the uterus and / or anterior wall is satisfactory.