局限性子宫腺肌症病灶切除术后联合GNRH-a、曼月乐治疗的效果观察

摘要

Objective To explore the limitations of adenomyosis lesion resection combined with gonadotropin releasing hormone -a (GNRH-a)and the clinical curative effect of Mirena therapy.Methods80 patients with adenomyosis were selected in our hospital from June2015 to August2016,and they were divided into4 groups by random number table,20 cases in each group. The4 groups of patients underwent laparoscopic adenomyosis lesion resection in the treatment of GNRH-a+,Mirena group also received GNRH-a and Mirena treatment,GNRH-a group received GNRH-a treatment group were treated with Mirena treatment,4 groups of clinical curative effect were compared.Results The VAS score,menstrual dysmenorrhea scores in GNRH-a+ group and Mirena group after6 months,1 years,2 years,were significantly lower than the GNRH-a group and the control group at the same time point(P<0.05);GNRH-a+ group and Mirena group after the Mirena was no difference between the VAS score and score of menstrual dysmenorrhea(P>0.05)at the same time. The postoperative VAS score,menstrual dysmenorrhea point score had no significant difference(P>0.05)in GNRH-a group compared with the control group. GNRH-a+ Mirena group and GNRH-a group after6 months and1 years of uterine volume were significantly smaler than the Mirena group and the control group(P<0.05),Mirena group after6 months and1 years of uterine volume was significantly less than the control group(P<0.05);GNRH-a+ group,Mirena Mirena group2 years after surgery of uterine volume was significantly lower than that of GNRH-a group and the control group(P<0.05),GNRH-a group was significantly lower than the control group (P<0.05). No cases of recurrence was found in GNRH-a+ Mirena group after6 months,1 years,2 years,the recurrence rates after operation at different time points were lower than those of other groups and had significant difference(P<0.05);the recurrence rate in group GNRH-a and Mirena group after1 and2 years was lower than the control group,and the difference was statisticaly significant(P<0.05). Conclusion The limitations of adenomyosis lesion resection combined with GNRH-a and Mirena treatment can effectively reduce the recurrence rate and improve curative effect.%目的 探讨局限性子宫腺肌症病灶切除术后联合促性腺激素释放激素-a(GNRH-a)、曼月乐治疗的效果.方法 2015年6月至2016年8月子宫腺肌症患者80例,随机分成4组,每组各20例.4组患者均行腹腔镜下子宫腺肌症病灶切除术治疗,GNRH-a+曼月乐组同时给予GNRH-a及曼月乐治疗,GNRH-a组单纯给予GNRH-a治疗,曼月乐组单纯给予曼月乐治疗,比较4组临床疗效.结果 GNRH-a+曼月乐组与曼月乐组术后6个月、1年、2年痛经VAS评分、月经量评分均显著低于GNRH-a组与对照组同时点(P<0.05);GNRH-a+曼月乐组与曼月乐组术后同时点痛经VAS评分、月经量评分比较差异无统计学意义(P>0.05);GNRH-a组与对照组术后同时点痛经VAS评分、月经量评分比较差异无统计学意义(P>0.05).GNRH-a+曼月乐组与GNRH-a组术后6个月、1年子宫体积均显著小于曼月乐组与对照组(P<0.05),曼月乐组术后6个月、1年子宫体积显著小于对照组(P<0.05);GNRH-a+曼月乐组、曼月乐组术后2年子宫体积显著小于GNRH-a组和对照组(P<0.05),GNRH-a组则显著小于对照组(P<0.05).GNRH-a+曼月乐组术后6个月、1年、2年均无一例复发,术后不同时点复发率均低于其余各组,术后1、2年与其余各组比较差异有统计学意义(P<0.05);GNRH-a组、曼月乐组术后1、2年复发率均低于对照组,且差异有统计学意义(P<0.05).结论 局限性子宫腺肌症病灶切除术后联合GNRH-a、曼月乐治疗可有效降低复发率,提高治疗效果.