促性腺激素释放激素激动剂在子宫体积大于孕14周的子宫肌瘤患者术前应用可行性

摘要

Objectives:To explore the preoperative application feasibility of gonadotropin-releasing hormone agonist for hysteromyoma patients with uterine volume over that of 14 weeks of gestation.Methods:60 uterine fibroids patients with uterine volume over that of 14 weeks of gestation in our hospital from January 2013 to January 2016 were selected as the observation group and received GnRHa subcutaneous injection before laparoscopic surgery,and 60 patients with volume below that of 14 weeks of gestation were selected as the control group.The changes in uterine tumors,intraoperative blood loss,operating time and other indicators between the two groups were compared.Results:In the observation group,the intraoperative blood loss,operation time and postoperative length of hospital stay was (280.35 ±85.73) mL,(82.75 ± 18.55) min and (4.09 ± 1.82) d respectively,without significant difference compared with those in the control group (P ＞ 0.05).Before surgery,the uterine volume in the observation group and control group was (319.25 ± 51.46) cm3 and (211.73 ± 15.08) cm3 respectively,with statistically significant difference (P ＞ 0.05).But the uterine fibroids volume in observation group significantly decreased after surgery,without significant difference compared with control group (P ＜ 0.05).The incidence of adverse reactions in the observation group (3.3％) was lower than that in the control group (21.7％),with statistically significant difference (P ＜ 0.05).Conclusion:Preoperative GnRHa injection is safe in treating hysteromyoma patients with uterine volume over that of 14 weeks of gestation,which can effectively improve uterine fibroid volume and worthy of clinical popularization and application.%目的:探究分析促性腺激素释放激素激动剂(GnRHa)在子宫体积＞孕14周的子宫肌瘤患者术前应用中的可行性.方法:随机选取我院在2013年1月至2016年1月期间收治的子宫体积＞孕14周的60例子宫肌瘤患者为研究对象,并将其作为本组研究中的观察组在腹腔镜手术前采取GnRHa皮下注射处理,同期选择子宫体积≤14周的子宫肌瘤患者为对照组,术前不做预处理.观察两组患者子宫肌瘤体积、术中出血量、手术时间等指标的变化情况.结果:观察组患者的术中出血量(280.35±85.73) mL、手术时间(82.75-18.55) min及术后住院时间(4.09±1.82)d与对照组比较无明显差异(P＞0.05);术前,观察组患者子宫体积(319.25±51.46)cm3与对照组(211.73±15.08) cm3比较具有统计学意义(P＞0.05);但是观察组患者的子宫肌瘤体积较手术前明显降低,且与对照组比较无显著差异(P＜0.05).且观察组患者的不良反应发生率(3.3％)低于对照组(21.7％),两组比较具有统计学意义(P＜0.05).结论:子宫体积＞孕14周的子宫肌瘤患者术前注射GnRHa具有较高的安全性,能够有效改善子宫肌瘤体积,有助于实施腹腔镜子宫肌瘤剔除术,值得临床推广应用.