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  

Short-term clinical curative effect of hysteroscopic resection combined with LNG-IUS treatment for uterine adenomyoma

作　　者：李晴晴[1] 王晓东[1] 韩璐[1] 

机构地区：[1]大连医科大学附属大连市妇幼保健院,辽宁大连116033

出　　处：《中国实用妇科与产科杂志》2017年第8期837-840,共4页Chinese Journal of Practical Gynecology and Obstetrics

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)%,P<0.05];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,P>0.05]。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,P<0.05],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。Objective To study the short-term clinical curative effect of hysteroscopic resection combined with LNGIUS treatment for uterine adenomyoma. Methods Eighteen cases of uterine adenomyoma who underwent hysteroscopic resection combined with LNG-IUS treatment from January 1,2014 to April 31,2015 in Dalian Maternity Hospital Affiliated to Dalian Medical University were selected. The operation time,intraoperative and postoperative complications were recorded;the improvement of dysmenorrhea,the changes of menstrual volume and uterine volume and the relapse of uterine adenomyoma were compared before and after surgery.Results In 18 cases,the operation time was（58.3±6.4）min,and there was no intraoperative or postoperative complications. Postoperative follow-up lasted for 6-12 months;in 14 cases of dysmenorrhea,2（2/14,14.3%）cases had partial remission,5（5/14,35.7%）cases were greatly relieved,and 5（5/14,35.7%）cases had complete remission,while 2（2/14,14.3%）cases had no menstruation. In 14 cases of menorrhagia,the volume was reduced and the period was shortened after the surgery,the difference being statistically significant（P〈0.05）.There was no significant difference in the postoperative period of the menstrual cycle（P〈0.05）. The anemia were corrected in 10 cases with different degree of anemia. The uterine volume were reduced in 6 months after the operation,the difference being statistically significant（P〈0.05）;follow-up ultrasonography showed no recurrence of uterine adenomyoma. In 8 patients（8/18）,the amount of vaginal discharge was more than before surgery;four cases（4/18）had a bit of vaginal bleeding within 3 months after the surgery,which recovered to normal in 3-6 months;1 patient（1/18）had weight increase;2 patients were unsatisfied because of much vaginal discharge,and the rest were satisfied.Conclusion The short-term curative effect of hysteroscopic resection combined with LNG-IUS treatment is significant in the treatment of uterine adenomyoma.

关 键 词：子宫腺肌瘤 宫腔镜 宫腔内左炔诺孕酮释放系统 

分 类 号：R713.4[医药卫生—妇产科学]