【作者】 隋哲峰；

【导师】 曾宪录；

【作者基本信息】 东北师范大学 ， 细胞生物学， 2008， 硕士

【摘要】 众所周知,子宫肌瘤是女性的常见病、多发病,其发病率为20-30%。子宫肌瘤诊断方法明确,在有辅助检查(如CT、彩超等)的情况下,确诊是比较容易的,但对其发病机制的研究并不十分明确。由于子宫肌瘤生长位置变化较大,而且在生长过程中可有变性、坏死、钙化等情况,因此出现并发症的情况也较多,治疗方案的分歧较大。尤其在我国经济、交通欠发达的偏远之地,医疗条件差,医疗仪器极为缺少,缺少诊断手段,致使农牧民妇女看病难、看病贵。本研究目的是通过对内蒙古呼伦贝尔市地区妇女子宫肌瘤的临床观察及病理改变分析,对该地区适龄妇女子宫肌瘤的诊断进行分析与评价,进而为医疗条件欠发达的边远地区子宫肌瘤的诊断提出新的临床诊断模型。通过对子宫肌瘤的临床病史和临床症状与病理类型关系的研究,探讨内蒙古边远落后地区子宫肌瘤患者病史和临床体检对诊断子宫肌瘤的价值。前期病例资料的收集对象主要是内蒙古呼伦贝尔市阿荣旗地区、海拉尔区、牙克石市和拉布大林地区四所二级甲等以上医院2000年1月1日至2006年12月份之前因临床症状住院手术的子宫肌瘤患者。后期病例资料收集对象是上述医院2007年1月份到12月份有临床症状并以子宫肌瘤为诊断住院治疗的患者,且术后病理诊断证实为子宫肌瘤的临床资料和病理资料。根据收集到的资料,我们建立了一个临床诊断模型(无B超情况下),并前瞻性的测试这个模型的诊断能力。结果临床医师利用这个模型的诊断结果与随后的病理检查没有统计学差异。四所医院间的诊断也没有统计学差异,不同研究者间的诊断结果一致性良好。在内蒙古少数民族边远旗县地区应用该诊断模型可以提高工作效率并降低农牧民治疗费用。本论文同时还发现肌瘤的生长部位与临床表现存在密切的关系。本文的研究对临床诊断在缺少辅助检查的情况下有一定的指导意义。更多还原

【Abstract】 It is well known that the method to diagnose fibroid is clear, which is common and multiple among the women, but it is difficult and expensive for the women living in the remote agricultural and pastoral areas that are the economically less developed regions and poor transport facilities and are lack of the ultrasonic diagnostic apparatuses. So the study intends to set a new standard for the diagnosis of fibroid in such areas in Hulunbuir Inner Mongolia in the way of clinical observation of fibroid and the analysis of the pathology changes to get the analysis and the appraisal from the diagnosis of fibroid for the women of the right age.We can discuss the case history of fibroid in the remote areas of Inner Mongolia and the value of clinical experience to the diagnosis of fibroid by the study for the relations among the clinical case history, clinical symptoms and pathology types of fibroid.The collection of the first-phase case materials are mainly from the patients who have the symptoms of fibroid in the four hospitals above of Two-grade and A-class in ARongQi Area,the city of Hailaer,the city of YaKeShi and LaBuDaLin Area ,Inner Mongolia from Jan 1st,2000 to December of 2006.The collection of the final-period case materials are mainly from the clinical materials and pathology materials of the patients who have the symptoms and are accepted in the hospital for the diagnosis of fibroid from January to December of 2007 , and the pathology diagnoses of them after operation are proved to be fibroid. According to the materials, a clinical model is made (without the ultrasonic diagnostic apparatuses), and the diagnosis ability of the forward-looking model is tested.There is no difference between the diagnosis results with such model and the pathology test in statistics. There is also no difference among the four hospitals, and the diagnosis results of different researchers are consistent well.Such diagnosis model used in the remote minority nationality of Inner Mongolia can improved the working efficiency and lower the cost of the treatment for the people living there.更多还原