Clinical Analysis Of The "U" Shaped And Forming Hysterectomy In The Treatment Of Adenomyosis

BackgroundAdenomyosis is a disease characterized by the presence of endometrial tissue in the myometrium of the uterus,and the ectopic endometrial tissue is composed of glands and stroma.According to the extent of infiltration of the myometrium by the ectopic endometrium,there are two manifestations of the disease:diffuse and localized.It is one of the most common gynecological diseases in clinic,and it occurs in pluripara who are 30-50 years old.Patients with adenomyosis may have multiple clinical manifestations,the most common symptoms are excessive menstruation and dysmenorrhea,secondary anemia or shock may occur in severe cases.Adenomyosis also has a great impact on pregnancy,which may cause infertility or abortion.It has caused serious adverse effects on the quality of life of the majority of women in physical,psychological and economic aspects.There are various treatments for adenomyosis,which are mainly divided into two types:drug treatment and surgical treatment.There is currently no drug that can cure the disease,and drug treatment often has poor results and a high recurrence rate.Although the traditional hysterectomy is a kind of radical treatment,the acceptance of hysterectomy becomes lower and lower with the younger age of onset of the disease and the improvement of women's quality of life.In recent years,conservative surgical treatment of adenomyosis has attracted more and more clinical attention.A large number of studies have proved that it can not only satisfy the patient's willingness to retain the uterus,but also avoid the adverse effects caused by total hysterectomy,and has significant therapeutic effects."U"shaped and forming hysterectomy is a mature conservative surgical treatment of adenomyosis.It has obvious curative effect and outstanding advantages,which is worthy of choice.ObjectiveThrough the analysis of the clinical data of patients with adenomyosis in Shandong Provincial Hospital,we studied the therapeutic effect of "U" shaped and forming hysterectomy on patients with adenomyosis,and analyzed its therapeutic advantages and clinical value.Method 1.Follow-up group:From January 2013 to January 2018.a retrospective study was conducted in 135 patients who were treated with "U" shaped and forming hysterectomy and diagnosed with adenomyosis by postoperative pathological biopsy in Shandong Provincial Hospital.We obtained relevant data through telephone follow-up and follow-up survey,and observed the degree of dysmenorrhea(1,6,12 months after surgery),uterine volume(1 month after surgery)and menstruation(menstrual cycle,menstrual period and menstrual volume)before and after operation.The changes were analyzed by statistical method to evaluate the clinical efficacy.2.Detection group:From May 2018 to January 2019,30 patients with adenomyosis who underwent "U" shaped and forming hysterectomy in Shandong Provincial Hospital were selected.Hemoglobin(Hb,before and 1 month after surgery),the levels of serum glucose chain antigen 125(CA125)and anti-Miller test tube hormone(AMH)were measured respectively.Statistical analysis was performed on the obtained data.ResultAfter "U" shaped and forming hysterectomy,the degree of dysmenorrhea,menstrual bleeding,menstrual period,uterine volume and serum glycoprotein antigen 125(CA125)levels were significantly lower than those before surgery(P<0.05).There was no significant change in menstrual cycle and serum anti-Muller test tube hormone(AMH)levels after surgery(P>0.05).The postoperative hemoglobin level increased significantly,that is,the anemia symptoms were significantly improved(P<0.05).In the follow-up group of 135 patients,there were 10 patients with hypomenorrhea(drip bleeding during menstrual period)or amenorrhea,and 7 patients with dysmenorrhea relapsed one year later.conclusionThe clinical effect of "U" hysterectomy is remarkable.It can effectively relieve clinical symptoms,relieve dysmenorrhea,reduce menstruation,improve the symptoms of anemia,and has no significant effect on ovarian function,which greatly improves the quality of life of patients.It is a worthy treatment for adenomyosis.