GnRH-a与LNG-IUS联合应用在宫腔镜下内突型子宫腺肌瘤病灶切除术中的价值  

Clinical observation of GnRH-a combined with LNG-IUS in the hysteroscopic treatment of uterine adenomyoma

作　　者：杜洁贤[1] 秦姗[1] 张新景 寇丽燕 王康[1] 田彩[1] DU Jie-xian;QIN Shan;ZHANG Xin-jing;KOU Li-yan;WANG Kang;TIAN Cai(Department of Gynecology, the Second Hospital of Hebei Medical University, Shijiazhuang050000, China;Department of Gynecology, Circular Chemical Park Hospital of Shijiazhuang,Hebei Province, Shijiazhuang 050056, China;Department of Gynecology, the People′sHospital of Linxi, Hebei Province, Linxi 054900, China)

机构地区：[1]河北医科大学第二医院妇科,河北石家庄050000 [2]河北省石家庄市循环化工园区医院妇科,河北石家庄050056 [3]河北省临西县人民医院妇科,河北临西054900

出　　处：《河北医科大学学报》2019年第8期902-906,共5页Journal of Hebei Medical University

基　　金：河北省医学科学研究重点课题(20160519)

摘　　要：目的探讨促性腺激素释放激素激动剂(gonadotropin release hormone agonist,GnRH-a)与左炔诺孕酮宫内缓释系统(levonorgestrel releasing intrauterine system,LNG-IUS)联合应用在宫腔镜下内突型子宫腺肌瘤病灶切除术中的价值。方法选取接受GnRH-a和 LNG-IUS 联合治疗的宫腔镜下内突型子宫腺肌瘤病灶切除术患者15例。记录手术时间、术中及术后并发症发生情况,比较术后痛经改善情况、经量变化、子宫体积变化及子宫腺肌瘤复发情况。结果患者均顺利完成手术,手术时间38~75 min,平均46.3 min。术中及术后均无明显并发症发生。随访12个月,随时间延长,经量评分和VRS评分呈逐渐降低趋势,子宫体积、血红蛋白和血清CA125水平也呈降低趋势(治疗后12个月时稍有升高),差异均有统计学意义( P < 0.05)。术后发生阴道分泌物明显增多2例,阴道点滴出血4例,曼月乐脱落1例、下移1例,体重明显增加1例,乳房胀痛2例,卵巢囊肿1例。结论 GnRH-a与LNG-IUS 联合应用在宫腔镜下内突型子宫腺肌瘤病灶切除术中的效果显著。Objective To investigate the clinical efficacy of gonadotropin release hormone agonist(GnRH-a) combined with levonorgestrel releasing intrauterine system(LNG-IUS) in the hysteroscopic treatment of uterine adenomyoma. Methods Fifteen cases of uterine adenomyoma who underwent hysteroscopic resection combined with GnRH-a and LNG-IUS treatment were selected. The operation time, intraoperative and postoperative complications were recorded. The improvement of dysmenorrhea, the changes of menstrual volume, uterine volume and the relapse of uterine adenomyoma were compared before and after surgery. Results All patients completed the operation successfully. The operation time was 38-75 min, with an average of 46.3 min,and there was no intraoperative or postoperative complications. Postoperative follow-up lasted for 12 months,with the extension of time, the menstrual score and VRS score showed a gradually decreasing trend, and the uterine volume, hemoglobin and serum CA125 level also showed a decreasing trend, slightly increased at 12 months after treatment. The difference was statistically significant( P <0.05). After operation, 2 cases had much more vaginal discharge than before, 4 caseshad a bit of vaginal bleeding, 1 case mirena fallen off, 1 case had weight increase, 1 case had ovarian cyst. Conclusion The effect of GnRH-a combined with LNG-IUS is significant in the hysteroscopic treatment of uterine adenomyoma.

关 键 词：子宫腺肌瘤 促性腺激素释放激素激动剂 左炔诺孕酮 

分 类 号：R711.74[医药卫生—妇产科学]