The Clinical Retrospective Study Of Perimenopausal Adenomyosis

Background and objective:Adenomyosis is a hormone-dependent disease and occurs in child-bearing periodwomen. In recent years, the incidence of perimenopausal period increased, the effect ofconservative treatment and drug therapy is poor，which was paid more and moreattention to us. The paper from many parts to analyze the risk factors ofperimenopausal adenomyosis: such as, the age，the occupation, the blood, bodymass index(BMI),maternal history, IUD, the history of gynecologic surgrey. The paperalso follow up the treatment of the patients for provided the scientific basis for itstreatment.Methods:Adopt the1:1proportion of case-control study method; choose from235caseswhose pathologies were diagnosed as adenomyosis the age45to55years old duringJanuary2012to December2014period when they were stayed in the Bethune firsthospital of Jilin University. And use the age of case study group as a reference torandomly select the unadenomyosis person who has been to our Medical Center to dothe health care check as the control group. They will fill in a questionnaire of theperimenopausal adenomysis. Establish a database and analyze with the SPSS21.0statistical software. Use the related factors of perimenopausal adenomysis to comparebetween the single-line groups, P <0.05can be granted as having a statistical significance, and to a statistically significant single factor through multi-factor LogisticBackward analysis the adenomysis induced associated risk factors (calculation ORvalue and95%confidence interval; OR is correlation coefficient, OR greater than1isrisk factors, OR less than1is protective factors).Results:1. From the age point of view, less than or equal to50years old are195cases(82.98%), more than50years old are40cases(17.02%).2. Through the single factor analysis showed that occupation, BMI, times ofpregnancy,menorrhagia, dysmenorrhea history, intrauterine operation history, pelvicsurgery history and IUD of P<0.05,they are relevant factors of perimenopausaladenomysis. Through multi-factor Logistic Backward showed that the OR of mentalworker, obesity and many times intrauterine operation are greater than1.3. From the235cases,72cases(31%) see a doctor because of repeated vaginalirregular bleeding,49cases(21%) see a doctor because of severe dysmenorrhea,42cases(18%) because of found hysteromyoma, etc.4. The CA125levels of perimenopausal adenomysis: the patients with secondarydysmenorrhea higher than primary dysmenorrhea higher than no dysmenorrhea,Diffuseadenomyosis higher than limited type of adenomysis.5. All patients were performed operation treatment, the main method are totalhysterectomy and subtotal hysterectomy(about90%).Follow up the two operation,thequality of sex life after surgery(P=0.0238<0.05) and the relief of chronic pelvic pain （P=0.0382<0.05） are very different, the former better than the latter on the relief ofchronic pelvic pain, but the former poorer than the latter on the quality of sex life aftersurgery.Conclution:1. Mental work, obesity and many times intrauterine operation are the independentrisk factors.2. The operative indication of perimenopasual adenomysis include anemia resultfrom repeated vaginal irregular bleeding, severe dysmenorrhea, found hysteromyomaor other gynecological diseases, and so on.3. The CA125levels of perimenopausal adenomysis is concerned with the typeof dysmenorrhea and the degree of lesion.4. The main operation treatment of perimenopasual adenomysis are totalhysterectomy and subtotal hysterectomy, two kinds of methods have their advantagesand disadvantages, the choice of methods should consider the patient‘s wishes.