腹腔镜手术联合促性腺激素释放激素激动剂治疗子宫腺肌瘤的效果

Effect of laparoscopic surgery combined with gonadotropin-releasing hormone agonist in treatment of patients with adenomyoma of uterus

  • 摘要: 目的 探讨腹腔镜下子宫腺肌瘤剜除术联合促性腺激素释放激素激动剂(GnRH-a)治疗子宫腺肌瘤的疗效。 方法 将270例子宫腺肌瘤患者分为对照组150例(腹腔镜下全子宫切除术)和观察组120例(腹腔镜下子宫腺肌瘤剜除术联合GnRH-a治疗)。比较2组手术相关指标、临床指标及复发情况。 结果 2组手术时间、术中出血量和住院时间比较,差异均无统计学意义(P>0.05)。观察组术后糖类抗原125、月经量评分、痛经评分均较术前降低,血红蛋白水平较术前提高,差异有统计学意义(P<0.05)。对照组手术前后糖类抗原125、血红蛋白水平比较,差异均有统计学意义(P<0.05)。观察组术后阴道B超复查发现子宫腺肌瘤复发6例,对照组4例患者术后仍有周期性下腹痛。 结论 腹腔镜下子宫腺肌瘤剜除术联合GnRH-a可缓解痛经症状,减少月经量。

     

    Abstract: Objective To investigate the effect of laparoscopic enucleation of uterine adenomyoma combined with gonadotropin releasing hormone agonist(GnRH-a)in the treatment of patients with uterine adenomyoma. Methods Totally 270 patients with uterine adenomyoma were divided into control group(n=150, treated with total laparoscopic hysterectomy)and observation group(n=120, treated with laparoscopic enucleation of uterine adenomyoma and GnRH-a). The operation-related indexes, clinical indexes and recurrence condition were compared between the two groups. Results There were no significant differences in operation time, intraoperative blood loss and hospital stay between the two groups(P>0.05). In the observation group, carbohydrate antigen 125, score of menstrual volume and score of dysmenorrhea were significantly lower than those before operation, while hemoglobin level was significantly higher than that before operation(P<0.05). There were significant differences in carbohydrate antigen 125 and hemoglobin levels in the control group before and after operation(P<0.05). In the observation group, 6 cases with recurrence of uterine adenomyoma were found by transvaginal ultrasonography after operation, and 4 cases in the control group still had periodic lower abdominal pain after operation. Conclusion Laparoscopic enucleation of uterine adenomyoma combined with GnRH-a can relieve dysmenorrhea and reduce menstrual volume.

     

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