腹腔镜子宫动脉阻断术联合曼月乐治疗子宫腺肌病的临床效果分析  

Clinical analysis of laparoscopic uterine artery occlusion combined with Mirena in the treatment of adenomyosis

作　　者：仲林 ZHONG Lin(Longkou People's Hospital,Longkou 265701,China)

机构地区：[1]龙口市人民医院妇科,265701

出　　处：《中国实用医药》2023年第13期114-117,共4页China Practical Medicine

摘　　要：目的 探究腹腔镜子宫动脉阻断术联合左炔诺孕酮宫内节育系统(商品名:曼月乐)治疗子宫腺肌病的临床效果。方法 86例子宫腺肌病患者,使用抽签法的方式分成对照组及研究组,各43例。对照组采用腹腔镜子宫动脉阻断术治疗,研究组采用腹腔镜子宫动脉阻断术联合曼月乐治疗。对比两组月经指标(痛经程度、经期时间、月经量),炎症因子[血清基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-9(MMP-9)]、子宫动脉血流指标[最大血流速度(Vmax)、最小血流速度(Vmin)、阻力指数(RI)],子宫内膜厚度、血清糖抗原-125(CA125)水平。结果 治疗后,研究组的痛经程度评分(2.83±0.58)分低于对照组的(3.91±1.94)分、经期时间(3.25±0.79)d短于对照组的(4.53±2.21)d、月经量(25.69±15.43)ml少于对照组的(42.82±28.04)ml,差异具有统计学意义(P<0.05)。治疗后,研究组的MMP-2(59.36±6.25)ng/ml、MMP-9(67.32±6.89)ng/ml低于对照组的(64.28±7.14)、(72.45±7.83)ng/ml,差异具有统计学意义(P<0.05)。治疗后,研究组的Vmax(20.35±3.58)cm/s、Vmin(9.29±2.37)cm/s低于对照组的(22.47±4.12)、(11.36±3.54)cm/s,RI(0.81±0.11)高于对照组的(0.72±0.13),差异具有统计学意义(P<0.05)。治疗后,研究组子宫内膜厚度(2.28±1.01)mm小于对照组的(3.21±1.43)mm、CA125(33.27±13.68)U/ml低于对照组的(43.74±14.82)U/ml,差异具有统计学意义(P<0.05)。结论 对子宫腺肌病患者实施腹腔镜子宫动脉阻断术联合曼月乐有着更好地治疗效果,可进一步控制患者炎症因子水平与子宫动脉血流指标,改善患者月经症状、子宫内膜厚度。Objective To investigate the clinical effect of laparoscopic uterine artery occlusion combined with levonorgestrel intrauterine system(trade name:Mirena)in the treatment of adenomyosis.Methods A total of 86 patients with adenomyosis were divided into control group and research group according to lottery method,with 43 cases in each group.The control group was treated with laparoscopic uterine artery occlusion,and the research group was treated with laparoscopic uterine artery occlusion and mirena.Both groups were compared in terms of menstrual indexes(dysmenorrhea degree,duration of menstruation,menstrual blood volume),inflammatory factors[serum matrix metalloproteinase-2(MMP-2),matrix metalloproteinase-9(MMP-9)],uterine artery blood flow indexes[maximum blood flow velocity(Vmax),minimum blood flow velocity(Vmin),resistance index(RI)],endometrial thickness,and serum carbohydrate antigen-125(CA125)level.Results After treatment,the dysmenorrhea degree score of(2.83±0.58)points in the research group was lower than that of(3.91±1.94)points in the control group;the duration of menstruation of(3.25±0.79)d in the research group was shorter than that of(4.53±2.21)d in the control group;the menstrual blood volume of(25.69±15.43)ml in the research group was less than that of(42.82±28.04)ml in the control group;the differences were statistically significant(P<0.05).After treatment,MMP-2 of(59.36±6.25)ng/ml and MMP-9 of(67.32±6.89)ng/ml in the research group were lower than those of(64.28±7.14)and(72.45±7.83)ng/ml in the control group,and the differences were statistically significant(P<0.05).After treatment,Vmax of(20.35±3.58)cm/s and Vmin of(9.29±2.37)cm/s in the research group were lower than those of(22.47±4.12)and(11.36±3.54)cm/s in the control group;RI of(0.81±0.11)in the research group was higher than that of(0.72±0.13)in the control group;the differences were statistically significant(P<0.05).After treatment,the endometrial thickness of(2.28±1.01)mm in the research group was less than that of(3.21±1

关 键 词：腹腔镜子宫动脉阻断术 左炔诺孕酮宫内节育系统 子宫腺肌病 

分 类 号：R713.4[医药卫生—妇产科学]