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  

The Effect Research of Laparoscopic Treatment Combine with GnRH-a after Operation in Localized Adenomyosis

作　　者：熊薇[1] 王飞飞[1] 罗利[1] 谭世桥[1] 

机构地区：[1]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,四川成都610041

出　　处：《实用妇产科杂志》2016年第12期930-932,共3页Journal of Practical Obstetrics and Gynecology

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(P<0.05)。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(P>0.05)。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(P<0.05)。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。Objective：To compare the treatment effect of adenomyosis patients between treated by removing the localized lesions of adenomyosis by laparoscopy and by the laproscopic operation combined with GnRH-a treatment. Methods ：The patients were divided into two groups according to the treatment method ：72 cases were treated by removing the localized lesions of adenomyosis by laparoscopy combined with GnRH-a treatment（study group） ;70 cases were treated by removing the localized lesions of adenomyosis by laparoscopy only. Follow-up the patients in the two groups by telephones in 6 months,12 months and 24 months after operation. The pregnan cy rate,dysmenorrhea improve and recurrence rate were compared between the two groups. Results：The prenancy rate in study group in 24 months after operation was higher than that of control group（27. 78% vs 12. 86%, P 〈0. 05） ,and the difference was statistically significant. The dysmenorrhea improve were 86. 11% and 81.43% in study group and control group, respectively, and the difference was not statistically significant（ P 〉 0. 05）. The recurrence rate after 24 months in study group was less than that of control group（8. 33% vs 18. 57%） ,and the difference was statistically significant（ P 〈0. 05）. Conclusions：Compared to removing the localized lesions of adenomyosis by laparoscopy only,the same laproscopic operation combined with GnRH-a treatment could improve the pregnancy rate,dysmenorrhea release and could reduce the recurrence rate in the patients with localized adenomyosis.

关 键 词：子宫腺肌病 腹腔镜 促性腺激素释放激素激动剂 不孕 妊娠 痛经 

分 类 号：R737.33[医药卫生—肿瘤]