子宫内膜异位症患者子宫体积的测量及其临床意义
Measurement of uterine volume in patients with endometriosis and its clinical significance
目的 使用超声测量子宫内膜异位症(内异症)未产患者的子宫体积并分析其临床意义.方法 选取2016年7月1日至2017年8月1日在北京大学第一医院住院的内异症未产患者107例作为内异症组,其中子宫内膜处于增殖期者59例、分泌期者48例,10例有妊娠流产史;同期住院的非内异症未产患者101例作为对照组,其中增殖期者71例、分泌期者30例,37例有妊娠流产史.患者均行腹腔镜手术,病理检查证实诊断.手术前均行经阴道或经直肠彩超检查测量子宫的长度、宽度和厚度,根据公式计算子宫体积.结果 内异症组患者的子宫体积[(69±26)cm3]大于对照组[(54± 18)cm3],两组比较,差异有统计学意义(P<0.01).内异症组中曾受孕的患者子宫体积[(78±34)cm3]大于未孕者[(68±25)cm3].子宫内膜厚度内异症组大于对照组[分别为(9.1±3.5)、(7.8±2.9)mm,P<0.05],且与子宫体积呈正相关(r=0.39,P<0.05).血红蛋白含量内异症组低于对照组[分别为(124± 12)、(131±10)g/L,P<0.01],且两组血红蛋白含量与子宫体积均呈负相关(r内异症组=-0.12、r对照组=-0.21, P均<0.05).内异症组痛经患者的子宫体积[(73±28)cm3]大于无痛经者[(62±19)cm3,P<0.01];子宫体积内异症组痛经患者和无痛经患者均大于对照组痛经患者[(55±20)cm3]和无痛经患者[(53± 17)cm3],分别比较,差异均有统计学意义(P均<0.05);且内异症组痛经程度与子宫体积呈正相关(r=0.20,P=0.042).内异症组Ⅳ期患者的子宫体积[(79±30)cm3]大于Ⅲ期[(58±14)cm3,P<0.01].结论 内异症患者的子宫体积增大,可能与痛经、月经过多和不孕相关.
更多Objective To measure the uterine volume by ultrasonic imaging in nullipara patients with endometriosis and analyze its clinical significance. Methods From July 1st, 2016 to August 1st, 2017, 107 cases of nullipara patients with endometriosis hospitalized in Peking University First Hospital were selected as endometriosis group. Among 107 cases, 59 cases were in proliferative phase of menstrual cycle, 48 cases were in secretory phase; and 10 cases had an abortion history.Totally 101 cases of patients without endometriosis operated for other benign disease during the same period were chosen as the control group. All patients underwent laparoscopic surgery, and the diagnosis was confirmed by pathology. The uterine size was measured by transvaginal or transrectal color Doppler ultrasound, and the uterine volume was calculated according to the known formula. Results The uterine volume of the endometriosis group [(69±26) cm3] was larger than that of the control group [(54±18) cm3, P<0.01]. In the endometriosis group, the uterine volume of patients with pregnant history [(78±34) cm3] was larger than that of patients without pregnant history [(68± 25) cm3]. The endometrial thickness in endometriosis group was higher than that of the control group [(9.1± 3.5) versus (7.8±2.9) mm, P<0.05], and positively correlated with the uterine volume (r=0.39, P<0.05). The hemoglobin in endometriosis group was lower than that in the control group [(124±12) versus (131±10) g/L, P<0.01], and was negatively correlated with the uterine volume in the two groups (rendometriosis=-0.12, rcontrol=-0.21; both P<0.05).The uterine volume of dysmenorrhea patients in the endometriosis group [(73±28) cm3] was greater than that of patients without dysmenorrhea [(62 ± 19) cm3, P<0.01]; both uterine volumes of patients with and without dysmenorrhea in endometriosis group were larger than those of patients with or without dysmenorrhea in the control group (P<0.05). The degree of dysmenorrhea in endometriosis group was positively correlated with the uterine volume (r=0.20, P=0.042). The uterine volume of stageⅣendometriosis patients [(79±30) cm3] was greater than that of stage Ⅲpatients in endometriosis group [(58±14) cm3, P<0.01]. Conclusion Patients with endometriosis are of increased uterine volume, which may be related to dysmenorrhea, menorrhagia and infertility.
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