目的 探讨术前应用促性腺激素释放激素激动剂( GnRH-a)对腹腔镜下治疗巨大子宫肌瘤的效果观察.方法 回顾性分析我院2014年2月—2017年7月收治的后壁巨大子宫肌瘤患者73例,按照治疗方法的不同分为观察组38例和对照组35例,两组患者术前均应用GnRH-a戈那瑞林治疗,1个月后观察组行腹腔镜子宫肌瘤剔除术,对照组给予常规开腹子宫肌瘤剔除术.观察两组GnRH-a治疗前1 d及手术治疗前1 d子宫肌瘤体积变化情况;两组患者手术时间、术中出血量及住院时间;术前及术后3 d两组孕激素(P)、雌二醇( E2) 、卵泡刺激素( FSH)和黄体生成素( LH)变化情况.结果 与药物治疗前比较,两组手术治疗前子宫肌瘤体积明显缩小(P0. 05) .结论 巨大子宫肌瘤患者术前应用GnRH-a可使肌瘤体积明显缩小,在此基础上行腹腔镜辅助子宫肌瘤剔除术临床效果满意,且不影响患者内分泌功能.%Objective To investigate the effect of preoperative gonadotropin-releasing hormone agonist ( GnRH-a) in application of patients with giant uterine fibroids undergoing laparoscopic myomectomy. Methods Clinical data of 73 cases of giant uterine fibroids in the posterior wall of the uterus who received treatment in our hos-pital was retrospectively analyzed. They were divided into observation group (n＝38) and control group (n＝35) ac-cording to different treatment methods. Both groups were treated with GnRH-a gonaline for one month before surgery. Subsequently, the observation group underwent laparoscopic myomectomy, and the control group received convention-al transabdominal myomectomy. Changes in uterine fibroid volume and fibroid volume 1 d before GnRH-a treatment and 1 d before surgery were observed. Duration of operation, intraoperative blood loss and duration of hospital stay were recorded. Before operation and 3 days after operation, changes in endocrine and ovarian function indicators of progesterone (P), estradiol (E2), follicle stimulating hormone (FSH) and luteinizing hormone (LH) were com-pared. Results Compared with those before drug treatment, the uterine volume and fibroid volume of patients in both groups were significantly reduced ( P0. 05) . Conclusion Preoperative GnRH-a treatment can significantly reduce the volume of fibroids in patients with giant uterine fibroids. On this basis, the clinical effect of laparoscopic-assisted myomectomy is satisfactory, which does not lead to impaired endocrine and ovarian function in patients.
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