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目的探讨子宫腺肌瘤保守手术的可行性。方法回顾性分析本院行保守手术的12例子宫腺肌瘤患者的临床资料。结果 12例均采用开腹手术,行保守性手术(局部病灶挖除术),手术顺利,术后予以药物配合左炔诺孕酮缓释系统(LNG-IUS)治疗,随访2~48个月,痛经全部缓解,CA125术前56.4~231.2 U/ml,平均值为(94.55±51.25)U/ml,术后6个月下降明显,平均值为(32.17±11.61)U/ml,和术前相比差异有统计学意义(t=4.656,P=0.001)。随诊超过6个月者10例(83.3%),复发率0%;不孕者2例,其中1例已孕32周。结论对于要求保留子宫的子宫腺肌瘤患者,在充分知情沟通下,行局部病灶挖除术,术后配合药物治疗是可行的,且近期复发率低。
Objective To investigate the feasibility of conservative surgery of adenomyoma. Methods The clinical data of 12 patients with adenomyoma of the uterus underwent conservative surgery in our hospital were analyzed retrospectively. Results All the 12 patients underwent laparotomy and conservative operation (local lesion excavation). The operation was successful. The patients were treated with levonorgestrel sustained-release system (LNG-IUS) after operation. The patients were followed up for 2-48 months , Dysmenorrhea all relieved, CA125 preoperative 56.4 ~ 231.2 U / ml, the average value was (94.55 ± 51.25) U / ml, 6 months after surgery decreased significantly, with an average of (32.17 ± 11.61) U / ml, and preoperative The difference was statistically significant (t = 4.656, P = 0.001). 10 cases (83.3%) were followed up for more than 6 months, the recurrence rate was 0%; 2 cases of infertility, 1 case of which had been 32 weeks pregnant. Conclusion For those patients with uterine adenomyosis who require uterus, partial and complete excision may be feasible under the condition of full informed communication, and postoperative combined with drug therapy is feasible, and the recent recurrence rate is low.