腹腔镜下子宫腺肌瘤局灶切除术联合GnRH-a治疗的效果研究

发布时间：2018-10-13 10:36

【摘要】：目的:比较腹腔镜下子宫腺肌瘤局灶切除术与术后联合促性腺激素释放激素激动剂(GnRH-a)在子宫腺肌瘤合并不孕症患者治疗中的效果。方法:根据治疗方法的不同将研究对象分为两组:行腹腔镜下子宫腺肌瘤局灶切除术联合GnRH-a治疗者为研究组(72例),仅行腹腔镜下局灶切除术为对照组(70例)。分别于术后6个月、12个月、24个月进行电话随访,比较两组患者妊娠率、痛经症状缓解及子宫腺肌病复发情况。结果:研究组术后24个月累计妊娠率(27.78%)高于对照组(12.86%),差异有统计学意义(P0.05)。研究组和对照组患者术后痛经缓解有效率分别为86.11%、81.43%,差异无统计学意义(P0.05)。2年随访期间研究组复发率(8.33%)低于对照组(18.57%),差异有统计学意义(P0.05)。结论:腹腔镜下局灶切除术后联合GnRH-a药物治疗可以改善子宫腺肌病患者的痛经症状,与单纯行腹腔镜下局灶切除术相比,联合治疗的妊娠率更高,短期内降低复发。
[Abstract]:Objective: to compare the effect of laparoscopic focal hysterectomy and postoperative combined gonadotropin releasing hormone agonist (GnRH-a) in the treatment of uterine adenomyoma with infertility. Methods: according to the different treatment methods, the subjects were divided into two groups: the study group (72 cases) treated with local hysterectomy combined with GnRH-a, and the control group (70 cases). The pregnancy rate, dysmenorrhea symptom relief and recrudescence of adenomyosis were compared between the two groups by telephone follow-up at 6 months, 12 months and 24 months after operation. Results: the cumulative pregnancy rate (27.78%) in the study group was significantly higher than that in the control group (12.86%) (P0.05). The effective rate of postoperative dysmenorrhea relief in the study group and the control group was 86.11 and 81.43 respectively (P0.05). The recurrence rate in the study group (8.33%) was lower than that in the control group (18.57%) during the 2-year follow-up (P0.05). Conclusion: combined treatment with GnRH-a after local laparoscopic resection can improve dysmenorrhea symptoms in patients with adenomyosis. Compared with local resection under laparoscopy, the pregnancy rate of combined therapy is higher and the recurrence is decreased in the short term.
【作者单位】：四川大学华西第二医院出生缺陷与相关妇儿疾病教育部重点实验室;
【分类号】：R737.33

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