腹腔镜下子宫肌瘤剔除术联合戈舍瑞林治疗子宫肌瘤对术后生长因子、微血管密度的影响  

Effect of laparoscopic myomectomy combined with goserelin on growth factor and microvessel density after hysteromyoma surgery

作　　者：张娜[1] 王书华 张梅娜[1] 王京京[1] ZHANG Na;WANG Shu-hua;ZHANG Mei-na(Department of Gynecology,Baoding First Central Hospital,Baoding Hebei 071000,China)

机构地区：[1]保定市第一中心医院妇科,河北保定071000

出　　处：《临床和实验医学杂志》2023年第6期636-639,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省医学科学研究课题计划项目(编号:2021B001359)。

摘　　要：目的探究腹腔镜下子宫肌瘤剔除术联合戈舍瑞林治疗子宫肌瘤对术后生长因子、微血管密度(MVD)的影响。方法采用前瞻性研究,选择2018年1月至2020年12月保定市第一中心医院收治的120例子宫肌瘤患者展开研究,以随机数字表法分为对照组(n=60)、观察组(n=60),对照组接受腹腔镜下子宫肌瘤剔除术,观察组给予腹腔镜下子宫肌瘤剔除术联合戈舍瑞林。比较两组患者术后3、6个月的生长因子[胰岛素样生长因子Ⅰ(IGF-Ⅰ)、表皮生长因子(EGF)、血管内皮生长因子(VEGF)]、MVD、子宫微循环状态指标[子宫动脉阻力指数(RI)、收缩期血流速度峰值(PSV)、搏动指数(PI)],并统计两组患者术后12个月子宫肌瘤复发率情况。结果术后3个月,观察组IGF-Ⅰ、EGF、VEGF水平分别为(202.48±20.60)ng/mL、(260.35±20.71)pg/mL、(102.65±10.15)pg/mL,均较对照组[(140.20±18.01)ng/mL、(140.20±18.01)pg/mL、(114.06±13.00)pg/mL]低,术后6个月,观察组IGF-Ⅰ、EGF、VEGF水平分别为(70.05±11.28)ng/mL、(235.69±14.21)pg/mL、(86.72±8.18)pg/mL,均较对照组[(97.68±16.23)ng/mL、(258.01±19.05)pg/mL、(100.68±10.11)pg/mL]低,差异均有统计学意义(P<0.05)。观察组术后3、6个月MVD为28.60±5.70、23.18±5.49,均较对照组(32.02±6.35、27.73±6.03)低,差异均有统计学意义(P<0.05)。术后3个月,观察组RI、PI分别为2.25±0.15、0.79±0.04,较对照组(1.93±0.19、0.60±0.03)高,PSV为40.05±4.68,较对照组(40.05±4.68)低;术后6个月,观察组RI、PI分别为2.87±0.31、1.02±0.10,较对照组(2.20±0.21、0.81±0.05)高,PSV为36.42±4.00,较对照组(39.01±5.47)低,差异均有统计学意义(P<0.05)。术后6个月观察组复发率为3.33%,较对照组18.33%低,差异有统计学意义(P<0.05)。结论腹腔镜下子宫肌瘤剔除术联合戈舍瑞林可改善生长因子及微血管密度,促进子宫微循环状态恢复,还能降低复发率,值得被推广。Objective To investigate the effect of laparoscopic myomectomy combined with goserelin on growth factor and microvessel density after hysteromyoma surgery.Methods A prospective study was conducted on 120 patients with hysteromyoma admitted to Baoding First Central Hospital from January 2018 to December 2020.They were randomly divided into control group(n=60)and observation group(n=60).The control group received laparoscopic myomectomy,and the observation group received laparoscopic myomectomy combined with Goserelin.The growth factors[insulin-like growth factor I(IGF-I),epidermal growth factor(EGF),vascular endothelial growth factor(VEGF)],MVD,uterine microcirculation status indicators[uterine artery resistance index(RI),peak systolic blood flow velocity(PSV),pulsatile index(PI)]of the two groups were compared at 3 and 6 months after operation,and the recurrence rate of uterine fibroids in the two groups at 12 months after operation was statistically analyzed.Results Three months after operation,the levels of IGF-Ⅰ,EGF,VEGF in the observation group were(202.48±20.60)ng/mL,(260.35±20.71)pg/mL,(102.65±10.15)pg/mL,which were lower than those in the control group[(140.20±18.01)ng/mL,(140.20±18.01)pg/mL,(114.06±13.00)pg/mL],six months after operation,the levels of IGF-Ⅰ,EGF,VEGF in the observation group were(70.05±11.28)ng/mL,(235.69±14.21)pg/mL,(86.72±8.18)pg/mL,which were lower than those in the control group[(97.68±16.23)ng/mL,(258.01±19.05)pg/mL and(100.68±10.11)pg/mL],the differences were statistically significant(P<0.05).MVD at 3 and 6 months in the observation group were 28.60±5.70,23.18±5.49,which were lower than those in the control group(32.02±6.35,27.73±6.03),the differences were statistically significant(P<0.05).Three months after operation,RI and PI in the observation group were 2.25±0.15,0.79±0.04,which were higher than those in the control group(1.93±0.19,0.60±0.03),PSV in the observation group was 40.05±4.68,which was lower than that in the control group(40.05±4.68);six months

关 键 词：腹腔镜下子宫肌瘤剔除术 戈舍瑞林 子宫肌瘤 生长因子 微血管密度 

分 类 号：R737.33[医药卫生—肿瘤]