Analyzing Clinical Characters Of 298 Cases Of The Degeneration Of Uterine Leiomyoma

Object: To investigate the clinical characters of the degeneration of uterine leiomyoma.Methods: During 2004 to 2008 in our hospital, there were 1785 cases of hospitalization in patients with uterine fibroids, of which 298 cases of uterine leiomyoma degeneration information were retrospectively analyzed from the variability of the incidence of uterine leiomyoma situation,the occurrence of trends,inrelevant factors, the pathological types, clinical manifestations, diagnosis and treatment.Results: In the total 1785 cases of patients with uterine fibroids during 2004 to 2008 in our hospital, there were 298 cases of the degeneration of uterine leiomyoma, the occurrence rate is 16.69 percent. The annual incidence of uterine leiomyoma degeneration was followed by the rate of 9.35%, 19.67%, 17.26%, 14.79%, 21.00%.over the past five years the incidence rate of uterine leiomyoma degeneration increased year by year, and in 2008 the incidence of uterine leiomyoma degeneration rate is 2.2 times to in 2004. In 298 cases of uterine myoma degeneration patients, those who are oldest 68 years old and the youngest 18 years old, average 42.70 years old, and more concentrated in the 31-50 years old, accounting for 77.18% of the total number of samples, particularly in the 41-50-year-old age group there is a peak (accounting for 52.68%). Patients with calcification is the oldest group (49.62±8.55) years old, red degeneration is the youngest group of patients (41.31±8.85) years old.Most degeneration myoma are the largest, a total of 215 cases (72%), the occurrence of degeneration of the fibroid is greater than 4cm in diameter from 240 cases (81%), less than 4cm were 58 cases (19%). 93 cases of leiomyoma are single (31.21%), 205 cases of multiple leiomyoma (68.79%). 272 cases of uterine myoma body, of which 31 cases of submucosal (10.40%), 56 cases of subserosal (18.79%), 185 cases of intramural muscle (62.08%), cervical myoma, 16 cases (5.37%), broad ligament muscle 10 cases of tumor (3.36%).The main clinical manifestations are 130 cases of menstrual changes (43.6%), abdominal mass in 45 cases (15.1%), 8 cases of vaginal bleeding (2.7%), abdominal pain in 69 cases (23.2%), 15 cases of compression symptoms (5%) .Between the number of birth and incidence of fibroid degeneration there was a negative correlation. Between the combined hyperlipidemia cardiovascular and cerebrovascular diseases and myoma degeneration there was a positive correlation. Pathological types includ 102 cases of hyaline degeneration (34.23%), 198 cases of mucoid degeneration (66.44%), 16 cases of cystic degeneration (5.37%), 16 cases of red degeneration (5.37%), calcification in 13 cases (4.36%), 3 cases of fat degeneration (1.01%) and one cases of sarcomatoid change (0.34%), due to a variety of hybrid variability, 298 cases of patients with fibroid degeneration have a total of 349 fibroid degenerations. There is statistical significance compared leiomyoma degeneration in 2004-2007 years to in 2008. From 2004 to 2008 the incidence of mucinous degeneration of uterine leiomyoma degeneration, hyaline degeneration have the highest incidence, and red degeneration has changed year-on-year decline, the incidence of malignant change is in the minimum. In 16 cases of red degeneration there were 2 cases occurred in the state of pregnancy (12.5%), 14 cases occurred in non-pregnancy (87.5%), however, 20% of fibroid degeneration during pregnancy occurred in patients with red degeneration, only 4.86% of fibroid degeneration during non- pregnancy period occurred in patients with red degeneration. 298 cases of patients with degeneration of myoma were conducted by ultrasound examination , of which 8 cases of fibroid pre-operative to consider the possibility of large variability, only four cases of a clear diagnosis, most are diagnosed by pathological. The number of patients who had hysterectomy is 110 cases (of which at the same time 17 cases of unilateral or bilateral removal of the annex, 1 a wide range of uterine surgery routine pelvic lymph node dissection), subhysterectomy 85 cases, myomectomy 103 cases, of which 12 cases of laparoscopic surgery under direct vision, three cases of hysteroscopic surgery.Conclusion: 1, The incidence rate of uterine leiomyoma degeneration increased year by year. 2, Most of the degeneration of uterine leiomyoma occurred in more than 4cm in diameter, multiple, muscle intramural fibroids. 3, Uterine leiomyoma degeneration occurred in the early menopause, and delivery frequency is negatively correlated with the cardiovascular and cerebrovascular disease was positively correlated 4, The incidence of mucinous degeneration of uterine leiomyoma degeneration, hyaline degeneration have the highest incidence, and red degeneration has changed year-on-year decline, the incidence of malignant change is in the minimum. 5, Uterine leiomyoma degeneration has a lower rate of preoperative diagnosis, most diagnosis rely on pathological results.