Hong Eliane Yuting, Lin Harvard Zhenjia, Fong Yoke Fai
Department of Obstetrics and Gynecology, National University Hospital, Singapore.
Astra Laparoscopic and Robotic Centre for Women and Fertility, Mount Elizabeth Novena Hospital, Singapore.
Gynecol Minim Invasive Ther. 2020 Apr 28;9(2):64-68. doi: 10.4103/GMIT.GMIT_77_19. eCollection 2020 Apr-Jun.
The objective of the study was to evaluate the incidence of venous thromboembolism (VTE) in patients who have been admitted for adenomyosis at our institute and describe their clinical characteristics and management.
A retrospective review of the medical records of all patients who were admitted to the gynecology ward between January 2015 and August 2016 was conducted, and all patients who had adenomyosis were included in this study. Clinical details that were evaluated included age, parity, body mass index, significant comorbidities, size of the uterus on physical examination, the size of the adenomyoma (if present) on pelvic ultrasonography, initial hemoglobin, and hematocrit on admission, whether blood transfusion was required, acute and long-term treatment and whether or not there were any associated VTE and treatment given.
Forty-one patients were included in this study. Five (12.2%) out of the 41 patients had associated VTE; all five had pulmonary embolism (PE), while two also had a concurrent left lower limb deep-vein thrombosis. Three out of the five patients had worsening menorrhagia following anticoagulation, which gonadotropin-releasing hormone analogs were effective in controlling. Four of the five patients eventually underwent a hysterectomy for long-term management of adenomyosis.
This case series describes a few clinical cases where VTE (particularly PE) has been observed with adenomyosis, the challenges in managing these patients, and effective treatment approaches.
本研究的目的是评估在我院因子宫腺肌病入院患者的静脉血栓栓塞症（VTE）发生率，并描述其临床特征及治疗情况。
对2015年1月至2016年8月间入住妇科病房的所有患者的病历进行回顾性分析，所有子宫腺肌病患者均纳入本研究。评估的临床细节包括年龄、产次、体重指数、显著合并症、体格检查时子宫大小、盆腔超声检查时腺肌瘤大小（如有）、入院时初始血红蛋白和血细胞比容、是否需要输血、急性和长期治疗以及是否存在任何相关的VTE及其治疗情况。
本研究纳入41例患者。41例患者中有5例（12.2%）合并VTE；5例均发生肺栓塞（PE），其中2例同时合并左下肢深静脉血栓形成。5例患者中有3例在抗凝治疗后月经过多加重，促性腺激素释放激素类似物可有效控制。5例患者中有4例最终接受了子宫切除术以进行子宫腺肌病的长期治疗。
本病例系列描述了一些子宫腺肌病患者发生VTE（尤其是PE）的临床病例、治疗这些患者的挑战以及有效的治疗方法。
