宫腔镜病灶切除术联合宫腔内左炔诺孕酮释放系统治疗内突型子宫腺肌瘤的近中期临床疗效观察

发布时间：2018-04-14 21:00

本文选题：子宫腺肌瘤 + 宫腔镜　；参考：《中国实用妇科与产科杂志》2017年08期

【摘要】：目的探讨宫腔镜下病灶切除术联合宫腔内左炔诺孕酮释放系统(LNG-IUS)治疗内突型子宫腺肌瘤的近中期临床疗效。方法对2014-01-01—2015-04-31期间大连医科大学附属大连市妇幼保健院18例子宫腺肌瘤患者行宫腔镜下病灶切除术联合LNG-IUS治疗,记录手术时间、术中及术后并发症情况,比较术前及术后的痛经改善情况、月经量的变化、子宫体积的变化及子宫腺肌瘤复发情况。结果 18例宫腔镜下子宫腺肌瘤病灶切除术手术时间(58.3±6.4)min,无术中、术后并发症。术后随访6~12个月。14例痛经患者,2例(2/14,14.3%)部分缓解,5例(5/14,35.7%)明显缓解,5例(5/14,35.7%)完全缓解,2例(2/14,14.3%)无月经来潮。14例经量多者,术后经量均减少、经期缩短,且差异有统计学意义[为术前的(29.3±0.7)%,P0.05];月经周期术前术后差异无统计学意义[(7.8±3.3)d vs.(4.3±2.2)d,P0.05]。10例合并不同程度贫血者贫血均纠正。术后6个月子宫体积均缩小,且差异有统计学意义[(232.5±94.5)cm3vs.(123.8±59.4)cm3,P0.05],随访期间彩超均未提示子宫腺肌瘤复发。8例(8/18)术后阴道分泌物量多、稀薄;4例(4/18)术后3个月内有点滴阴道流血,均于3~6个月渐恢复正常;1例(1/18)体重增加。2例(2/18)因阴道分泌物较多表示满意度欠佳,余均满意。结论宫腔镜下子宫腺肌瘤病灶切除术联合LNG-IUS治疗内突型子宫腺肌瘤近中期疗效明显。
[Abstract]:Objective to evaluate the efficacy of hysteroscopic resection combined with intrauterine levonorgestrel releasing system (LNG-IUS) in the treatment of intrauterine adenomyoma.Methods during 2014-01-2015-04-31, 18 patients with uterine adenomyoma were treated with hysteroscopic resection combined with LNG-IUS in Dalian Maternal and Child Health Care Institute affiliated to Dalian Medical University. The operative time, intraoperative and postoperative complications were recorded.The improvement of dysmenorrhea, the change of menstrual volume, the volume of uterus and the recurrence of adenomyoma were compared before and after operation.Results 18 cases of uterine adenomyoma were resected under hysteroscope for 58.3 卤6.4 min.Postoperative follow-up of 6 to 12 months. 14 patients with dysmenorrhea (2 patients with 2 / 14 / 14 / 14.3) partial relief (5 / 14 / 35. 7) 5 / 14 / 35. 7) 5 / 14 / 35. 7) completely relieved 2 / 2 / 14 / 14 / 14.3) No menstruation. 14 cases with more than the amount of menstruation, the postoperative menstrual volume was reduced, the menstrual period was shortened.The difference was statistically significant [29. 3 卤0. 7 卤0. 7 卤0. 05], but there was no significant difference before and after menstrual cycle [7. 8 卤3. 3 d vs.(4.3 卤2. 2 d P. 05] .All the 10 patients with anemia of different degrees were corrected.The volume of uterus decreased in 6 months after operation, and the difference was statistically significant [232.5 卤94.5)cm3vs.(123.8 卤59.4 cm ~ (3) P 0.05]. During the follow-up, the volume of vaginal secretions was more than 8 / 18 in 8 / 18 cases of recurrent adenomyoma of uterus, and there was little vaginal bleeding within 3 months after operation.In 3 ~ 6 months, 1 case (1 / 18) gained 2 / 18 (2 / 18) weight gain (2 / 18). Satisfaction with vaginal discharge was not satisfactory, and the rest was satisfied.Conclusion hysteroscopic resection of adenomyoma combined with LNG-IUS is effective in the near and medium term.
【作者单位】：大连医科大学附属大连市妇幼保健院;
【分类号】：R737.33

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