Li Xuelian, Liu Xishi, Guo Sun-Wei
Department of Gynecology, Fudan University, Shanghai, China; Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai OB/GYN Hospital, Fudan University, Shanghai, China.
J Obstet Gynaecol Res. 2014 Feb;40(2):485-94. doi: 10.1111/jog.12211. Epub 2013 Oct 22.
The aim of this study was to determine the frequency of various symptoms and their associated characteristics in women with adenomyosis who underwent hysterectomy, and to determine which symptoms are likely to go with which others in these patients.
In 2007, 1697 consecutive patients underwent hysterectomy in our hospital. Among them, 734 (43.3%) were histologically confirmed to have adenomyosis, and 710 of them were premenopausal. The medical charts of all 734 patients were retrieved, and their demographic, clinical information and postoperative findings were recorded. We used the Verbal Descriptor Scale to measure the preoperative severity of dysmenorrhea. The Apriori Algorithm was used for mining the association of different symptoms.
Among the 710 premenopausal patients, only 4.5% of them had no symptoms. Dysmenorrhea was the most common complaint, occurring in 81.7% of patients. Dysmenorrhea co-occurred most frequently with menorrhagia. The presence of adhesion, presence of endometriosis, complaint of menorrhagia, longer duration of disease, gravidity, palpable pain during pelvic examination, and diffuse adenomyosis were positively associated with the severity of dysmenorrhea. Age, severity of dysmenorrhea, and complaint of metrorrhagia were positively associated with the risk of menorrhagia.
Dysmenorrhea is the most common complaint in women with adenomyosis, which often goes with that of menorrhagia. Adenomyosis often co-occurs with endometriosis and leiomyomas. Various factors are associated with the risk of having different symptoms.
本研究旨在确定接受子宫切除术的子宫腺肌病女性各种症状的发生频率及其相关特征，并确定这些患者中哪些症状可能与其他症状同时出现。
2007年，我院1697例连续接受子宫切除术的患者。其中，734例（43.3%）经组织学证实患有子宫腺肌病，其中710例为绝经前患者。检索了所有734例患者的病历，并记录了他们的人口统计学、临床信息和术后结果。我们使用言语描述量表来测量术前痛经的严重程度。采用Apriori算法挖掘不同症状之间的关联。
在710例绝经前患者中，只有4.5%没有症状。痛经是最常见的主诉，81.7%的患者出现痛经。痛经最常与月经过多同时出现。粘连的存在、子宫内膜异位症的存在、月经过多的主诉、疾病持续时间较长、妊娠次数、盆腔检查时可触及的疼痛以及弥漫性子宫腺肌病与痛经的严重程度呈正相关。年龄、痛经严重程度和子宫出血的主诉与月经过多的风险呈正相关。
痛经是子宫腺肌病女性最常见的主诉，常与月经过多同时出现。子宫腺肌病常与子宫内膜异位症和平滑肌瘤同时发生。多种因素与出现不同症状的风险相关。
