手术前应用GnRH-a治疗子宫腺肌病的临床疗效研究

Clinical Efficacy of GnRH-a in the Treatment of Adenomyosis Before Operation

目的:探讨行全子宫切除术术前应用促性腺激素释放激素激动剂(GnRH-a)治疗子宫腺肌病的临床应用价值。方法:选取2014年1月-2016年8月莆田学院附属医院行腹腔镜全子宫切除的子宫腺肌病患者65例,按照随机数字表法分为治疗组30例和对照组35例。治疗组术前予皮下注射GnRH-a两个周期后再行手术,对照组直接手术,比较两组患者的手术时间、术中出血量、中转开腹率、术后病率、住院天数等指标。结果:治疗组患者术前血红蛋白含量、子宫最大径及CA125水平均优于注射GnRH-a前,比较差异均有统计学意义(P<0.05)。治疗组患者手术时间、术中出血量、中转开腹率、术后病率、住院天数几个均优于对照组,差异均有统计学意义(P<0.05)。结论:子宫腺肌病行子宫切除术前使用GnRH-a预处理具有出血少、住院时间短、恢复快等优点,在严格掌握手术适应证情况下,值得临床推广。

Objective： To investigate the clinical value of gonadotropin releasing hormone agonist（ GnRH-a ） in the treatment of adenomyosis before total hysterectomy. Method： From January 2014 to August 2016, 65 patients with adenomyosis who hnderwent laparoscopic hysterectomy in Affiliated Hospital of Putian College were collected, and divided into treatment group （ 30 patients ） and control group （ 35 patients ） .The treatment group was treated with 2 cycles subcutaneous injection GnRH-a before operation, while control group direct received operation.The operation time, intraoperative blood loss volume, conversion to laparotomy rate, postoperative morbidity and hospital stays of two groups were compared.Result： The hemoglobin content, the maximum diameter and CA125 level of treatment group after injected GnRH-a were better than those before, the differences were statistically significant （ P〈0.05 ） .Operation time, intraoperative blood loss, conversion to laparotomy, postoperative morbidity and hospitalization stays of treatment group were better than those of the control group, the differences were statistically significant （P〈0.05） .Conclusion： GnRH-a pretreatment before hysterectomy for adenomyosis has advantages like less bleeding, shorter hospital stays, faster recovery, which worthy of clinical promotion after mastery the hysterectomy indication.