The Clinical Analysis Of3939Cases With Uterine Leiomyomas

Objective: To provide references for much humanized, invidualized andstandard treatment of uterine leiomyomas, the clinical data of patients with uterineleiomyomas was retrospectively reviewed to summary the incidence trend of uterineleiomyoma, clinical characteristics, outcome and the change of operation mode.Methods: There are3939patients treated with surgery and pathologicallydiagnosed as Uterine Leiomyomas in our hospital from January2001to December2012. Using the retrospective comparative methods to analyze the clinical data,chi-square test and nonparametric test of statistical methods are applied for analyze.1,The incidence trend of uterine leiomyomas and the related factors in the lastdecade;2,The incidence trend and the clinical characteristics in the nulliparous patientswith uterine leiomyomas;3,The changes in pathological degeneration of uterine leiomyoma and clinicalanalysis of relevant factors;4,The patholigical changes in different types of uterine leiomyoma variants andthe comparson of the clincal characteristic;5,To analyze the change of uterine leimomyomas surgery approach and involvedfactors.Results:1,In the last decades,1414patients with uterine leiomyoma have been treatedfrom2001to2006, the proportion is35.9%, and2525patients with uterineleiomyoma have been treated from2007to2012, the proportion is35.9%. In thestudy of patients’ onset age, in2001-2006group, the proportion of patients who isyounger than35years is12.7%, which is less than2007-2012group. The comparison shows no statistical significance (P>0.05). The number of patients older than55in2001-2006group is2.1%, slightly less than2007-2012group. There is statisticalsignificance between them (P <0.05).2,Through the comparison of clinical characteristics among patients fromdifferent age groups, the proportion of patients with no symptoms among those whoyounger than35is as large as31.5％，and as the growth of the age, the proportion isgradually decreased (P <0.05). The major symptoms of patients in all age groups aremenstrual changes and abdominal pain.3,There are367nulliparious patients in this group of data，the proportion is9.3%.The proportion of patients with no symptom in nulliparious patients is as high as42.8%, and major clinical manifestations of symptomatic patients who are childlessare abdominal pain (18.8%) and lower abdomen mass(16.1%). The major clinicalsymptoms in nulliparious patients are abdominal pain (18.8%) and lower abdomenmass (16.1%).4, There are1057patients with degeneration of uterine leiomyomas in the groupof data, accounting for26.8%. The main pathological type is hyaline degeneration,accounting for50.7％. The incidence rate of degeneration of uterine leiomyomas from2001to2006is11.1％，which is up to35.6％from2007to2012.There is a statisticalsignificance between the them (P <0.05). The study of incidence rate in different agegroups demonstrate that, the patients with the age older than55have the highestprobability of degeneration, which is49.2％. The comparisons of incidence rateamong different age groups have statistical differences (P <0.05). The averagemaximum diameter of uterine leiomyoma with degeneration is58.03±30.045mm，which is larger than average maximum diameter of ordinary uterine leiomyoma（51.40±28.390mm），there is a statistical difference between them (P <0.05).5,There are519cases of uterine leiomyoma variants in the group of data,accounting for13.2%. The main pathological type is cellular leiomyoma, accountingfor83.1％.Among different age groups，the patients with the age younger25have thehighest probability, up to49.2％. The comparison of incidence rate among different age groups shows statistical differences (P <0.05).6, The study about selection of surgery approaches among different age groupsdemonstrate that retain uterine operation accounts for29.8%in2001-2006group, andincreased to41.3%in2007-2012group. Subtotal-hysterectomy account for34.9%in2001-2006group and decreased to20.5%. Hysterectomy in account for35.3%in2001-2006group and slightly increased to38.1%in2007-2012group. There is significant difference ofsurgery approaches selection between different age group (P <0.05).7, The main surgery approaches of patient with preoperative complications arehysterectomy and subtotal-hysterectomy, which occupy statistically higher proportion than generalpatients (P <0.05). The main surgery approaches of patients with operation history arehysterectomy and subtotal-hysterectomy, which occupy statistically higher proportion than generalpatients (P <0.05).Conclusion:1,The incidence rate of uterine leiomyoma has increasing trend, thosepost-menopause women who are elder than55have a higher incidence rate. Youngpatients and childless patients always show no clinical symptoms.2,The incidence rate of uterine leiomyoma degeneration is increasing annually,the main type is hyaline degeneration, the size of myoma degenerated is usually largeand women older than55owns a higher probability of myoma degeneration.3,The size of myoma of uterine leiomyoma variants is usually large, the mainpathological type is cellular leiomyoma, patients younger than25occupy higherprobability of incidence rate.4,The selection of retain uterine surgery has increasing trend, those who havepreoperative complications or operation history usually choose hysterectomy andsubtotal-hysterectomy.