摘要
目的探讨醋酸亮丙瑞林预处理联合腹腔镜下子宫肌瘤剔除术治疗巨大子宫肌瘤的可行性和安全性。方法选取92例巨大子宫肌瘤患者,随机分为观察组与对照组,每组各46例。对照组直接行腹腔镜下子宫肌瘤剔除术,观察组先采用醋酸亮丙瑞林治疗3个月,再行腹腔镜下子宫肌瘤剔除术。比较观察组预处理前后的子宫及肌瘤体积,血清雌二醇(E2)、卵泡刺激素(FSH)和黄体生成素(LH)水平;比较2组腹腔镜下子宫肌瘤剔除术围手术期情况。随访3个月,观察患者术后恢复情况以及肌瘤有无复发。结果观察组预处理后,盆腔疼痛症状明显缓解,月经量减少,子宫、肌瘤体积均缩小,血清E2、FSH、LH水平均降低(P<0.05)。2组患者均在腹腔镜下完成子宫肌瘤剔除术,观察组术中出血量、盆腔引流量,下床活动时间、住院时间均少于对照组(P<0.05)。术后随访3个月,子宫基本恢复正常,未见复发患者。结论醋酸亮丙瑞林预处理后降低了子宫肌瘤患者的血清性激素水平,缩小了肌瘤体积,为腹腔镜下子宫肌瘤剔除术创造了有利条件,术中创伤更小,患者术后恢复迅速。醋酸亮丙瑞林预处理联合腹腔镜下子宫肌瘤剔除术治疗巨大子宫肌瘤是一种比较优化、可行和安全的序贯方案。
Objective To explore the feasibility and safety on treatment of large uterine fibroids by leuprorelin acetate pretreatment with laparoscopic myomectomy. Methods A total of 92 cases with huge uterine myoma were selected,and were randomly divided into observation group and control group,46 cases per group. Patients in control group were given laparoscopic myomectomy directly,yet patients in observation group were given leuprorelin acetate pretreatment for 3months,given laparoscopic myomectomy afterwards. Volume of uterine and fibroid,serum estradiol（ E2）,follicle stimulating hormone（ FSH） and luteinizing hormone（ LH） level in observation group were compared before and after pretreatment,perioperative situation of laparoscopic myomectomy in two groups were compared also,and followed up for 3 months to observe postoperative recovery and hysteromyoma recurrence. Results After pretreatment,dysmenorrhea symptoms of patients in observation group were obviously relieved,menstruation amount was reduced,volume of uterine and fibroid were shrinked,and serum E2,FSH,LH levels were decreased（ P 〈0. 05）. Patients in two groups were all successfully finished laparoscopic myomectomy,and bleeding amount during surgery,pelvic drainage,ambulation time,hospital stay were all lower than those in control group（ P 〈0. 05）. Following up for 3 months,patients＇ uterus were all recovered,and without recurrence. Conclusion It reduced uterine fibroids patients＇ serum sex hormones by pretreatment with leuprorelin acetate,reduced leiomyoma volume,and created favorable conditions for laparoscopic myomectomy,also with less injury during surgery,so patients recover rapider,and it provided a relatively optimal,feasible and safe sequential scheme on treatment of large uterine fibroids by leuprorelin acetate pretreatment with laparoscopic myomectomy.
出处
《中华全科医学》
2015年第8期1293-1295,1309,共4页
Chinese Journal of General Practice
关键词
子宫肌瘤
腹腔镜
序贯治疗
适应证
Myoma of uterus
Laparoscope
Sequential treatment
Indication
