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目的:研究促性腺激素释放激素激动剂(Gn RHa)用于大黏膜下子宫肌瘤宫腔镜手术前的效果以及对手术的影响。方法:选取了2015年2月至2016年2月惠州市第一人民医院收治的子宫肌瘤患者33例,患者在手术前和术后28 d使用戈舍瑞林(Gn RHa的一种)皮下注射,观察患者在手术期间肌瘤体积、血红蛋白水平改变情况。结果:患者在使用GnRHa后血红蛋白值由(90.23±20.17)g·L~(-1)升为(117.09±11.2)g·L~(-1),差异具有统计学意义(P<0.01);子宫肌瘤平均体积由(128.01±122.0)cm~3减小为(88.341±52.4)cm~3,差异具有统计学意义(P<0.05)。GnRHa治疗后肌瘤体积缩小程度与治疗前肌瘤体积呈正相关(r=0.816,P<0.01)。同时本次所有患者均顺利完成手术,无中转开腹者。结论:在大黏膜下子宫肌瘤手术治疗前使用Gn RHa可显著提升患者血红蛋白水平,缩小子宫肌瘤体积,对宫腔镜手术顺利完成具有重要作用。
Objective: To study the effect of gonadotropin-releasing hormone agonist (Gn RHa) before hysteroscopic surgery for large submucous myoma and its effect on surgery. Methods: Thirty-three patients with uterine fibroids who were treated in Huizhou First People’s Hospital from February 2015 to February 2016 were selected. Patients were treated with goserelin (a kind of Gn RHa) subcutaneously before and 28 days after operation Injection, observation of patients during fibroids volume, hemoglobin level changes. Results: The hemoglobin value of patients with GnRHa increased from (90.23 ± 20.17) g · L -1 to (117.09 ± 11.2) g · L -1, with statistical significance (P <0.01). The average volume of uterine fibroids decreased from (128.01 ± 122.0) cm ~ 3 to (88.341 ± 52.4) cm ~ 3, with statistical significance (P <0.05). The extent of fibroids shrinking after GnRHa treatment was positively correlated with the volume of myoma before treatment (r = 0.816, P <0.01). At the same time all patients were successfully completed surgery, no transit oppression. Conclusion: The use of Gn RHa prior to surgical treatment of large submucous uterine fibroids can significantly improve hemoglobin level, reduce the volume of uterine fibroids and play an important role in the successful completion of hysteroscopic surgery.