腹腔镜术前联合亮丙瑞林他莫昔芬治疗对巨大子宫肌瘤术后疗效病情复发的影响  

Impact of triptorelin combined with tamoxifen before laparoscopy on postoperative efficacy and recurrence of patients withgi⁃ant uterine leiomyoma

作　　者：杨丽波 付大磊 王娜 崔金凤 YANG Libo;FU Dalei;WANG Na;CUI Jinfeng(Department of Gynecology,Zhumadian Hospital of Traditional Chinese Medicine,Zhumadian 463002,China;Department of Surgery,Zhumadian Hospital of Traditional Chinese Medicine,Zhumadian 463002,China;Department of Osteoarthritis,Zhumadian Hospital of Traditional Chinese Medicine,Zhumadian 463002,China)

机构地区：[1]驻马店市中医院妇科,河南驻马店463002 [2]驻马店市中医院外科,河南驻马店463002 [3]驻马店市中医院骨关节科,河南驻马店463002

出　　处：《安徽医学》2023年第6期666-669,共4页Anhui Medical Journal

摘　　要：目的探讨腹腔镜术前联合亮丙瑞林、他莫昔芬治疗对巨大子宫肌瘤术后疗效、病情复发的影响。方法回顾性分析2019年10月至2021年10月在驻马店市中医院诊治的96例巨大子宫肌瘤患者的临床资料,所有患者均行腹腔镜子宫肌瘤剔除术(LSHM),根据术前预处理方法的不同,分为亮丙瑞林组(n=49,应用亮丙瑞林)和联合组(n=47,在亮丙瑞林组基础上应用他莫昔芬)。比较两组患者性激素水平、肌瘤最大直径、手术相关指标、术后疗效及术后1年内肌瘤复发率情况。结果两组患者入组时、术日性激素水平及肿瘤最大直径的差值比较,差异均有统计学意义(P<0.05)。联合组患者手术用时、术中失血量、肛门排气时间及术后住院天数均少于亮丙瑞林组,差异有统计学意义(P<0.05)。联合组术后总有效率为97.87%,高于亮丙瑞林组,差异有统计学意义(P<0.05)联合组术后1年无一例复发,亮丙瑞林组复发率为12.24%,差异有统计学意义(P<0.05)。结论巨大子宫肌瘤患者于LSHM术前应用亮丙瑞林联合他莫昔芬进行预处理,可有效优化手术相关指标,明显提高术后疗效,显著降低复发率。Objective To investigate the impacts of triptorelin combined with tamoxifen before laparoscopy on the postoperative efficacy and recurrence of patients with giant uterine leiomyoma.Methods The clinical data of 96 patients with giant uterine leiomyoma diagnosed and treated in Zhumadian Hospital of Traditional Chinese Medicine from October 2019 to October 2021 were analyzed retrospectively.All patients underwent laparoscopic myomectomy(LSHM),and were divided into triptorelin group(n=49,triptorelin)and combined group(n=47,tamoxifen was used on the basis of triptorelin group)according to different preoperative pretreatment methods.The sex hormone level,the maximum diameter of leiomyoma,the operation-related indexes,the postoperative efficacy and the recurrence rate of leiomyoma within one year after operation were compared between the two groups.Results The difference in sex hormone level and the maximum diameter of tumor between the two groups was statistically significant(P<0.05).The operative time,intraoperative blood loss,anal exhaust time and postoperative hospitalization days of the combined group were all less than those of leuprelin group,with statistical significance(P<0.05).The total postoperative effective rate of the combined group was 97.87%,higher than that of the lepraline group,and the difference was statistically significant(P<0.05).The recurrence rate one year after operation in the combined group was 0%,lower than 12.24%in leprerelin group,and the difference was statistically significant(P<0.05).Conclusions Pretreatment with leuprorelin and tamoxifen before LSHM for patients with giant uterine leiomyoma can effectively optimize the operation-related indexes,obviously improve the postoperative efficacy and evidently reduce the recurrence rate.

关 键 词：子宫肌瘤 亮丙瑞林 他莫昔芬 腹腔镜手术 病情复发 

分 类 号：R737.33[医药卫生—肿瘤]