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目的:研究分析子宫体积>孕14周患者腹腔镜下子宫肌瘤剔除术前应用促性腺激素释放激素激动剂(GnRHa)的临床作用和价值。方法:本研究采用回顾性分析方法,选取37例术前3个月使用GnRHa进行预治疗子宫体积>孕14周的子宫肌瘤患者作为观察组,术前未进行预治疗的子宫体积>孕14周子宫肌瘤患者42例作为对照组,比较两组患者的子宫体积、肌瘤体积及手术情况差异。结果:观察组患者手术前的子宫体积为(627.9±109.6)cm3,最大肌瘤体积为(147.9±73.2)cm3,血红蛋白(Hb)为(92.4±15.6)g·L-1,与观察组用药前相比差异均具有统计学意义(P<0.05);观察组患者的手术时间为(68.9±18.4)min、术中出血量为(67.5±15.5)ml,均显著低于对照组患者(P<0.05);观察组的术后Hb水平为(118.5±14.9)g·L-1,显著高于对照组(P<0.05)。结论:子宫体积>孕14周患者腹腔镜下子宫肌瘤剔除术前应用GnRHa预治疗有助于改善患者的贫血症状、缩小肌瘤体积,为后期手术治疗创造有利条件,但用药过程中也存在一些轻度不良反应。
Objective: To study the clinical effect and value of gonadotropin-releasing hormone agonist (GnRHa) before laparoscopic myomectomy in patients with uterine volume> 14 weeks gestation. Methods: In this study, retrospective analysis was used in this study. 37 cases of uterine fibroids pre-treated with GnRHa for pre-treatment of uterine volume> 14 weeks pregnant were selected as observation group. Preoperative uterine volume> Forty-two patients with uterine fibroids were divided into two groups as the control group, and the difference of uterine volume, fibroid volume and operation condition between the two groups were compared. Results: The volume of uterus before operation in our observation group was (627.9 ± 109.6) cm3, the maximum myoma volume was (147.9 ± 73.2) cm3, and the hemoglobin (Hb) was (92.4 ± 15.6) g · L-1. (P <0.05). The operation time of the observation group was (68.9 ± 18.4) min and the intraoperative blood loss was (67.5 ± 15.5) ml, both of which were significantly lower than those of the control group (P <0.05). The postoperative Hb level in the observation group was (118.5 ± 14.9) g · L-1, which was significantly higher than that in the control group (P <0.05). Conclusions: Pretreatment with GnRHa before laparoscopic myomectomy in patients with uterine volume> 14 weeks of pregnancy can help to improve anemia symptoms, reduce the size of fibroids, and create favorable conditions for subsequent surgical treatment, but there is also a Some mild side effects.