Morán C, Murillo H A, de la Cruz S I, Barahona E, Carranza-Lira S
Hospital de Gineco Obstetricia Luis Castelazo Ayala, Instituto Mexicano del Seguro Social, México D.F.
Ginecol Obstet Mex. 1998 Sep;66:358-61.
Leiomyomatosis is less frequent in old woman, and its clinical and histological characteristic in late postmenopause are unknown. Uterine leiomyomas were confirmed histologically in 14 out of 69 patients (20.2%) who were 65 or older and in whom a vaginal hysterectomy was performed. Another group without myomas was paired by age to the study group. In both groups, the uterine volume and the minor diameter of the uterus were compared, as well as age at menarche, menopause and duration of the menstrual life. Statistical analysis was done with ANOVA. It was observed, as expected, that uterine volumes of women with leiomyomatosis were significantly greater (p < 0.01) than those of women that did not have myomas; however, the smaller uterine diameters were not significantly different between the two groups, which is an important finding for surgical treatment of these patients. In addition, the menstrual life of patients with myomas was significantly greater (p < 0.04) than that of women without leiomyomatosis. In conclusion, one fifth women 65 years old or older can present myomas and consequently an increase in uterine volume, but without increase in minor diameters. Furthermore, the greater menstrual life span must be recognized as possible risk factor for the presence of leiomyomatosis.
平滑肌瘤病在老年女性中较为少见,其在绝经后期的临床和组织学特征尚不清楚。在69例65岁及以上接受阴道子宫切除术的患者中,有14例(20.2%)经组织学证实患有子宫平滑肌瘤。另一组无肌瘤的患者按年龄与研究组配对。比较了两组患者的子宫体积、子宫短径,以及初潮年龄、绝经年龄和月经持续时间。采用方差分析进行统计学分析。正如预期的那样,观察到平滑肌瘤病患者的子宫体积明显大于无肌瘤患者(p < 0.01);然而,两组之间较小的子宫直径并无显著差异,这对于这些患者的手术治疗是一个重要发现。此外,有肌瘤患者的月经持续时间明显长于无平滑肌瘤病的女性(p < 0.04)。总之,五分之一的65岁及以上女性可能患有肌瘤,从而导致子宫体积增大,但短径并无增加。此外,更长的月经持续时间必须被视为平滑肌瘤病存在的可能危险因素。