子宫肌瘤大于孕14周体积患者术前使用促性腺激素释放激素激动剂效果评价.docVIP

子宫肌瘤大于孕14周体积患者术前使用促性腺激素释放激素激动剂效果评价 　　【摘要】目的：研究术前使用促性腺激素释放激素激动剂（GnRHa）对提升子宫体积14孕周子宫肌瘤患者手术效果的临床价值。方法：将2010年1月至2014年1月于我院择期手术、子宫体积14孕周的子宫肌瘤患者纳为观察组（n=20），术前行GnRHa皮下注射处理，停药3个月后行腹腔镜手术；择同期行腹腔镜手术、子宫体积≤14孕周的子宫肌瘤患者为对照组（n=20）。统计对比两组患者子宫及肿瘤体积、血红蛋白（Hb），以评价GnRHa预处理效果；统计对比两组手术时间、术中出血量、输血情况等指标，以评价手术效果。结果：（1）观察组患者用药后Hb水平明显升高而子宫及肌瘤体积明显下降（P005），观察组子宫体积仍明显大于对照组（P14孕周子宫肌瘤患者的肿瘤体积，并提升Hb水平，从而使患者满足腹腔镜手术指征，保证腹腔镜手术效果，提升患者预后。 　　【关键词】子宫肌瘤；促性腺激素释放激素激动剂；腹腔镜全子宫切除术；腹腔镜子宫肌瘤剔除术 　　Effect of pre-operative gonadotropin releasing hormone agonists to myoma patients with large uterusof over 14 weeks’ pregnancy sizeZHANG Ying， YANG Jun. Reproductive Center， The Centre Hospital of Shantou city， Shantou 515031， China 　　【Abstract】Objectives： To study the clinical effect on increasing operation effect by pre-operative applying gonadotropin releasing hormone agonist （GnRHa） to myoma patients with large uterus of over 14 weeks’ pregnancy size. Methods： 20 myoma patients with large uterus of over 14 weeks’ pregnancy size in our hospital from Jan.2010 to Jan.2014 were selected as the observation group. They received preoperative GnRHa subcutaneous injection， and laparoscopic surgery after 3 months of pre-operative process. 20 patients accepted by our hospital in the same time， whose uterus were not larger than 14 weeks’ pregnancy size， were chosen as the control group. Their uterus and tumors volume， as well as hemoglobin level （Hb） were recorded in order to show the effect of pre-operative applying GnRHa. Their operative time， bleeding volume， blood transfusion and other indicators of surgery were also recorded to evaluate the effect of operation. Results： i=1*roman. The levels of Hb in patients of observation group after treatment increased obviously and uterine and fibroid volume decreased significantly （P005）， but the uterus volume of patients in observation group were larger than the that of the control group （P 　　【Key words】Uterine fibroids； Gonadotropin releasing hormone agonist； Laparoscopic hysterect