Fletcher H, Wharfe G, Williams N P, Gordon-Strachan G, Pedican M, Brooks A
Department of Obstetrics and Gynaecology, Pathology and Internal Medicine, University of the West Indies, Mona, Kingston, Jamaica.
J Obstet Gynaecol. 2009 Nov;29(8):732-6. doi: 10.3109/01443610903165545.
This study describes cases of fibroids with venous thromboembolism (VTE) managed at UHWI between the years 1999-2004. We examined records to find patients with fibroids and VTE diagnosed before or after surgery. We found 438 women with VTE and 72 of these (16.4%) with fibroids. A total of 1,979 patients had fibroids during the period; cases were therefore 3.63% of fibroids. Cases were younger, median age 44 years than the total cohort: the median age was 57 and the mean age was 55.43 (SD 19.87) p = 0.000 about 9.5 years older than cases. Age over 50 years was less common in cases 27% vs 52% p = 0.0001 as were other risk factors for VTE such as cancer 4.9 vs 14% p = 0.03; diabetes 8.6 vs 25.2% p = 0.004 and cardiac disease 8.6% vs 26.6% p = 0.002 . However, thrombocytosis was more frequent, 23% vs 9% p = 0.008. Other risk factors were not significantly different. A total of 21 cases (29.1%) had surgery for fibroids; 15 (71.4%) hysterectomy, and six (28.5%) myomectomy. Most cases 67/72 (93%) had VTE without surgery. Of the five cases with VTE after surgery for fibroids, none had prophylactic heparin. Of the cases, 15 died--23% of women with VTE at PM and 0.8% of those with fibroids.
本研究描述了1999年至2004年间在英国威尔士大学医院（UHWI）接受治疗的患有静脉血栓栓塞（VTE）的子宫肌瘤病例。我们查阅记录以找出在手术前后被诊断出患有子宫肌瘤和VTE的患者。我们发现438名患有VTE的女性，其中72名（16.4%）患有子宫肌瘤。在此期间共有1979名患者患有子宫肌瘤；因此，病例数占子宫肌瘤患者总数的3.63%。病例组患者较年轻，中位年龄为44岁，而整个队列的中位年龄为57岁，平均年龄为55.43岁（标准差19.87），病例组比整个队列大约大9.5岁，p = 0.000。50岁以上的患者在病例组中较少见，占27%，而在整个队列中占52%，p = 0.0001，VTE的其他风险因素如癌症在病例组中占4.9%，在整个队列中占14%，p = 0.03；糖尿病在病例组中占8.6%，在整个队列中占25.2%，p = 0.004；心脏病在病例组中占8.6%，在整个队列中占26.6%，p = 0.002。然而，血小板增多症在病例组中更常见，占23%，而在整个队列中占9%，p = 0.008。其他风险因素无显著差异。共有21例（29.1%）因子宫肌瘤接受了手术；15例（71.4%）进行了子宫切除术，6例（28.5%）进行了肌瘤切除术。大多数病例，即72例中的67例（93%）在未手术的情况下发生了VTE。在因子宫肌瘤手术后发生VTE的5例病例中，无一例使用预防性肝素。在这些病例中，有15例死亡——占VTE女性患者的23%，占子宫肌瘤患者的0.8%。
