Clinical Analysis Of196Cases Of All Ages Special Type Of Uterine Leiomyoma

Objective: The purpose of this study is to understand the incidence trend, the relatedfactors,the pathological changes,the diagnosis and change of treatment, in order to achieve amore comprehensive understanding on it, to avoid excessive or insufficient treatments, bythe retrospective analysis the clinical data of patients in different age groups of special typeof uterine leiomyoma.Methods: A total of1350patients treated by operation and confirmed by pathologicaldiagnosis for uterine leiomyoma in the obstetrics and gynecology at the first hospital of jilinuniversity from2008to2012were collected, in which196cases of special types ofleiomyoma is diagnosed with the diagnostic standard of Obstetrics and Gynecology forspecial type of uterine leiomyoma. Analysis the clinical data of196cases of special type ofuterine leiomyoma from the incidence trend, related factors, pathological changes, clinicalmanifestations, diagnosis and treatment4aspects by retrospective comparative methods.Results:1.From2008to the end of2012, special type of uterine leiomyoma showed arising trend year by year, the young women (age <40) rising trend more obvious.2. Theminimum special types of uterine leiomyoma patient was18years old, maximum was68years old, mean age was40.5±2.7years old. Its distribution is close to the normaldistribution, the most concentrated in the36to45years old, which is similar to commonuterine leiomyoma, between age of36to45this10years special types of leiomyoma casesare enrichment, amounted to108cases, accounted for55.1%of cases of special types.3.Urban and rural living environment may influence the incidence of the special types ofuterine leiomyoma, this group of materials82(41.8%) cases were located in rural areas,114(58.2%) cases distributed in cities and towns. Composition were analyzed on patientsoccupation, special type of the self-employed and employees and urban housewife rateseparately the first three in each occupation, industrial workers, staff of institutions and theincidence is relatively low.4.56cases of patients in this group visited a doctoe for thereason of menstrual changes, which is the highest proportion of28.6%, then53cases (27%)patients had no clinical symptoms only found in physical examination, compared with theordinary leiomyoma P>0.05, no significant difference.123cases are single myoma,73casesare multiple myoma, only a few small are special type, basic for submucous myoma. There were32.1%patients with myoma degeneration, the most common was myxoid degenerationaccounted for18.9%, cystic degeneration accounted for4.1%, with statistical significance.5.Pregnancy, delivery and abortion times were associated with the special type of uterineleiomyomas, pregnancy and term delivery had statistical significance with special type ofuterine leiomyomas, P<0.05.For birthed patients, the number of special types of uterineleiomyomas decreased with the increasing of delivery time; while,in the barren but hadartificial abortion history patients, the number was ncrease with the artificial abortion times.6. Celluar uterine leiomyoma was the most common type of the special type of uterineleiomyomas, accounting for all subtypes71.9%(141/196), followed by the rest were bizarreleiomyoma, fatty leiomyoma, epithelioid leiomyoma, High mitotic phase leiomyoma,vascular type leiomyoma, with lymphocytic infiltration leiomyoma and intravenousleiomyoma; peritoneal dissemination leiomyoma was at least, only1cases, accounting for0.5%. Difference various types of special subtypes leiomyomas had different agedistribution,both the number of the total of special types leiomyoma and the number of thespecific leiomyoma subtypes were biggest between36to45this10years.7.The mainoperation mode of special types of uterine leiomyoma was uterine myoma resection, inrecent years, the proportion of minimally invasive operation by hysteroscopy andlaparoscopic was increasing year by year, the proportion of hysterectomy and subtotalhysterectomy operation was decreased.Conclusion:1.Special type of uterine leiomyoma show a rising trend year by year, the youngwomen(age <40) rising trend more obvious.2.Special types of uterine leiomyoma are more common in city, the occupationdistribution was difference between surban and rural patients, the highest proportion were incity clerk,and rural self-employed, the lowest proportion were in city workers and ruralfarmers3.Special type of uterine leiomyoma cases in fertile patients decreased with increasingnumber of parturition, and at the same times of childbirth patients increased with the times ofinduced abortion decreased, which decreased with increasing number of pregnancy; in theabsence of the fertility of the history of artificial abortion patients, adding special leiomyomawith artificial abortion the increased number of.4.Celluar uterine leiomyoma was the most common type of the special type of uterineleiomyomas, the patients age was enriched. 5. Special type of uterine leiomyoma had higher incidence in special position,the cervicaland broad ligament, and the incidence rate in intramural, subserous and submucous was low.