促性腺激素释放激素激动剂预防腹腔镜子宫肌瘤剔除术后复发的疗效观察  

Efficacy of GnRH-a in the prevention of recurrence of uterine myoma after laparoscopic myomectomy

作　　者：边立华[1] 王楠[1] 范文生[1] 叶明侠[1] 王敏[1] 孟元光[1] 

机构地区：[1]解放军总医院妇产科,北京100853

出　　处：《解放军医学院学报》2017年第3期199-201,共3页Academic Journal of Chinese PLA Medical School

基　　金：国家自然科学基金项目(81571411)~~

摘　　要：目的观察腹腔镜子宫肌瘤剔除术患者术后使用促性腺激素释放激素激动剂(gonadotropin-releasing hormone-agonist,GnRH-a)预防肌瘤复发的临床疗效。方法选取我院2012年6月-2014年6月行腹腔镜子宫肌瘤剔除术者,根据术后是否采用GnRH-a治疗(醋酸戈舍瑞林缓释植入剂3.6 mg/注射用醋酸亮丙瑞林微球3.75 mg,皮下注射,1次/28 d,术后治疗3~6个月)分为观察组和对照组。比较两组术后子宫体积变化和术后复发情况。结果共纳入子宫肌瘤病例82例,其中观察组33例,对照组49例,两组病例一般情况差异无统计学意义。观察组与对照组子宫体积在术后6个月[(64.1±19.6)cm^3 vs(80.3±27.2)cm^3]、12个月[(59.0±23.7)cm^3 vs(83.7±28.8)cm^3]、18个月[(62.9±24.3)cm^3 vs(88.2±32.3)cm^3]和24个月[(66.7±27.1)cm^3 vs(95.6±34.9)cm^3]比较,观察组均小于对照组(P<0.01)。观察组在术后18个月有2例(6.1%)、24个月有3例(9.1%)复发,对照组18个月有11例(22.4%)、24个月有15例(30.6%)复发,观察组复发率低于对照组,差异有统计学意义(P<0.05)。结论腹腔镜子宫肌瘤剔除术后GnRH-a治疗,可在24个月内缩小子宫体积,降低复发率。Objective To observe the clinical effecacy of GnRH-a in the prevention of recurrence of uterine myoma after laparoscopicmyomectomy. Methods Patients admitted to our hospital from June 2012 to June 2014 with uterine myoma were selected, ofwhich 82 cases were performed laparoscopic myomectomy. All the 82 patients were divided into the observation group （GnRH-atreatment group, 33 cases） and control group （simple operation group, 49 cases）, respectively. The uterine volume changes andpostoperative recurrence of the two groups were compared. Results The difference of general data between the two groups was notsignificant. Uterine volumes in observation group were less than those in control group at 6 months （64.1±19.6 vs 80.3±27.2） cm3,12 months （59.0±23.7 vs 83.7±28.8） cm3, 18 months （62.9±24.3 vs 88.2±32.3） cm3 and 24 months （66.7±27.1 vs 95.6±34.9）cm3, with statistically significant differences （P 〈 0.001, respectively）. Postoperative recurrence rate of observation group werelower than those of control group at 18 months （6.1% vs 22.4%, P=0.046） and 24 months （9.1% vs 30.6%, P=0.021） after operation,respectively. Conclusion GnRH-a can reduce uterine volume and recurrence in patients with uterine myoma after laparoscopicmyomectomy.

关 键 词：子宫肌瘤 促性腺激素释放激素激动剂 腹腔镜子宫肌瘤剔除术 

分 类 号：R713-4[医药卫生—妇产科学]