曲普瑞林应用于腹腔镜大子宫肌瘤切除术前153例

Clinical Significance of Triptorelin Application before Laparoscopic Resection of Large Uterine Fibroids in 153 Cases

目的观察腹腔镜下大子宫肌瘤切除术前应用曲普瑞林缩小肌瘤利于手术的可行性及临床应用价值。方法选取子宫肌瘤超过12孕周大小的患者153例(研究组)行腹腔镜大子宫肌瘤切除术,术前于月经周期的第2天肌肉注射曲普瑞林3.75 mg,每月1次,共3个月。以术前未用曲普瑞林施行同样手术的大子宫肌瘤患者148例作对照组。结果研究组在腹腔镜下完成手术,术中、术后均无并发症发生,子宫肌瘤体积、术中平均出血量及血红蛋白水平与对照组比较,差异有统计学意义(P<0.05)。结论腹腔镜下大子宫肌瘤切除术前应用曲普瑞林,可明显缩小子宫及子宫肌瘤体积;减少子宫血流,使术中出血量明显下降;提高血红蛋白水平并改善贫血的相关症状。

Objective To investigate the feasibility and clinical application value of using triptorelin for reducing fibroids to benefit surgery before laparoscopic resection of large uterine fibroids. Methods A hundred and fifty- three cases of uterine fibroids with the size more than 12-week pregnancy were selected and performed the laparoseopic resection of large uterine fibroids. On 2 d of the menstrual cycle before surgery, triptorelin 3.75 mg was muscularly injected, once a month for 3 months. Other 148 cases of large uterine fibroid without using triptorelin before surgery were as the control group. Results A hundred and fifty- three cases in the study group were successfully completed the laparoscopic surgery and no intraoperative and postoperative complications occurred. The volume of uter- ine fibroid, mean intraoperative bleeding volume and hemoglobin concentration showed statistical difference compared with the control group （P 〈 0. 05）. Conclusion Before laparoscopic myomectomy of large uterine fibroid, using triptorelin can significantly shrink the size of the uterus and uterine fibroids, and decrease uterine blood flow, which could obviously reduce intraoperative blood loss, increase the hemoglobin concentration and improve the anemia- related symptoms, and is worth being clinically popularized.