Obstetrics & gynecology science

Korean Society of Obstetrics and Gynecology (대한산부인과학회)
권호 표지

A clinical analysis of uterine myoma

자궁근종에 관한 임상통계학적 연구

Park, Jeong-Kuy;Yoon, Seok-Geun;Kim, Sung-Ug;Lee, Jeong-Heon;Kim, Jong-Hyeon;Yi, Seung-Yeun;Jeong, So-Mang;Rheu, Chul-Hee;Kim, Jong-Duk
박정규;윤석근;김성욱;이정헌;김종현;이승연;정소망;류철희;김종덕

  • Published : 20050200
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Abstract

From January 1998 to December 2002, 3,259 cases of uterine myoma were treated at the department of Obstetrics and Gynecology, Chunbuk National University Hospital. A clinico-stastical study of uterine myoma was perfomed to analyse the clinical characteristics. The results were as follows. 1. The incidence of uterine myoma was 9.8%. 2. The most frequent age group was 40 to 49 years, and the mean age was 44.6 years. 3. The average parity was 2.29, the infertility was 163 cases (5.0%), while the primary infertility, 2.4%, the secondary, 2.6% respectively. 4. The most frequent chief complaint was pain which was observed in 2,648 cases (81.2%), abnormal bleeding in 1,775 cases (53.8%). dizziness in 270 cases (8.3%). 5. The corporeal myomas were observed in 2,879 cases (95.9%). Intramural type was observed in 1,687 cases (58.2%), subserous in 529 cases (18.2%), submucous in 191 cases (6.5%), mixed type in 483 cases (17.0%). 6. The mean value of preoperative hemoglobin was 11.1 gm/dL, and the anemia (Hb<10.0 gm/dL) was observed in 481 cases (11.7%). Transfusion was necessary in 215 cases (6.5%). 7. The mean weight of the uterine myoma operated was 335.0 gm. 8. The secondary change of myoma was found in 54 cases (1.7%) and hyaline degeneration was the most common (0.7%). 9. The most common associated condition was chronic cervicitis, which was observed in 784 cases (24.1%). 10. The gynecologic surgery were performed in 1,456 cases (44.7%), medical therapy in 25 cases (0.8%), observation in 1,792 cases (55.0%). 11. Total abdominal hysterectomy was performed in 607 cases (41.7%), total abdominal hysterectomy with unilateral adnexectomy in 115 cases (7.9%), total abdominal hysterectomy with both adnexectomy in 164 cases (11.3%), subtotal hysterectomy in 304 cases (20.9%), myomectomy in 153 cases (10.5%), total laparoscopic hysterectomy in 103 cases (7.0%), laparoscopy assisted vaginal hysterectomy in 8 cases (0.5%), diagnostic laparoscopy in 2 cases (0.1%) respectively. 12. The postoperative complication were found in 113 cases (3.5%) and the wound infection was the most common (1.6%). 13. The mean period of hospitalization was 8 days, and the period less than 10 days in 1,177 cases (80.9%).

목적: 자궁근종은 자궁 및 자궁부속기에서 발생하는 종양 가운데 가장 흔한 양성질환이다. 최근 5년 동안 전북대학교 병원에 내원한 사이의 부인과 환자 중에 자궁근종으로 진단된 3,259명을 대상으로 자궁근종의 최근 발생율과 진단, 치료 방법, 예후에 관한 임상적 고찰을 통해 자궁근종의 특성을 알아보고자 하였다. 연구 방법: 1998년 1월 1일부터 2002년 12월 31일까지 기간동안 전북대학교병원 산부인과에 내원한 환자 중에서 자궁 근종으로 진단받은 환자를 대상으로 이들의 임상기록지를 바탕으로 그 발생빈도, 호발연령, 산과력, 주증상, 진단율, 병리학적 소견, 치료방법 등을 조사 검토하여 결과를 비교분석 하였다. 결과: 1. 자궁근종의 빈도는 9.8%이었다. 2. 연령분포는 40-49세가 60.2%로 가장 많았고 평균연령은 44.6세였다. 3. 임신경험이 한번도 없는 경우가 5.0%, 평균임신횟수는 4.1회, 평균 분만 횟수는 2.3회였다. 불임인 경우는 5.1%에서 관찰되었으며 이중 원발성은 4.1%, 속발성은 1.0%이었다. 4. 주소가 동통인 경우가 81.2%, 이상자궁출혈이 53.8%, 현기증이 8.3% 순이었다. 5. 발생부위는 체부가 95.9%, 경부가 2.3%, 광인대내가 0.3%순이었다. 조직학적으로는 근내형이 58.2%, 장막하형이 18.2%, 혼합형이 17.0%, 점막하형이 6.5%의 순이었다. 6. 절제된 자궁과 자궁근핵적출술을 시행한 자궁근종의 무게는 300-399 g인 경우가 가장 많았고 평균무게는 335.0g이었다. 7. 평균 혈색소치는 11.1 g/dL이었으며, 혈색소치가 10.0 g/dL 이하인 경우가 11.7%이었다. 8. 자궁근종의 이차변성은 1.7%에서 보였으며 초자양성 변성이 0.7%로 가장 많았다. 9. 자궁근종과 동반된 질환은 57.2%였고 만성자궁경부염이 24.1%로 가장 많았다. 10. 치료는 수술이 44.7%, 약물 치료가 0.8%, 추적관찰이 55.0% 이었다. 수술 방법은 41.7%가 복식전자궁적출술만을, 19.2%가 복식전자궁적출술 및 자궁부속기적출술을 시행하였으며, 20.9%에서 복식부분자궁적출술, 10.5에서 근핵적출술이 시행되었다. 11. 수술 후 합병증은 3.5%에서 나타났으며, 수술 후 상처 감염이 1.6%로 가장 많았으며 수술에 따른 심각한 합병증이나 사망한 경우는 없었다. 12. 평균 입원기간은 8일이며, 10일 이내의 경우가 80.9%로 대부분을 차지하였다. 결론: 자궁근종의 빈도는 9.8%이었으며, 평균연령은 44.6세였고, 주소는 동통인 경우가 81.2%로 가장 많았고, 발생부위는 체부가 95.9%로 조직학적으로는 근내형이 58.2%이 가장 많았다. 자궁근종의 이차변성은 1.7%에서 보였으며 치료는 수술이 44.7%로 복식전자궁적출술이 41.7%로 가장 많이 시행되었다.

Keywords

References

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