GnRHa用于大子宫子宫肌瘤腹腔镜手术前治疗疗效的前瞻性研究

A prospective study of GnRHa in the treatment of large uterus and myoma before laparoscopic surgery

目的探讨腹腔镜手术前2个月应用GnRHa的效果及安全性。方法收集28例子宫肌瘤患者,均在术前2个月开始给予GnRHa治疗,观察治疗后子宫体积、子宫肌瘤体积、Hb水平、手术完成及副反应情况。结果治疗后患者Hb明显高于治疗前,差异有统计学意义(P<0.05)。GnRHa治疗后肌瘤体积较治疗前明显缩小,差异有统计学意义(P<0.05);所有患者均顺利完成腹腔镜手术,潮热、多汗8例,肝功能指标轻度升高1例。未有因不能耐受而退出治疗者。结论术前2个月给予GnRHa辅助治疗子宫肌瘤,能明显缩小肌瘤体积,增加患者Hb水平,降低手术难度,使子宫体积超过孕14周的肌瘤患者能完成腹腔镜微创手术成为可能。

Objective To evaluate the efficacy and safety of GnRHa in 2 months before laparoscopic surgery. Methods 28 cases of hysteromyoma patients were collected and treated with GnRHa at 2 months before operation. The volume of uterus, the volume of myoma of uterus, the level of Hb, the completion of operation and the side effects were observed. Results After treatment, the Hb of patients was significantly higher than that before treatment(P<0.05). After GnRHa treatment, tumor volume was significantly reduced than before treatment(P<0.05); all patients were successfully completed laparoscopic surgery, 8 cases of hot flushes, sweating, liver function index increased slightly in 1 cases. Not withdrawn from the treatment because of intolerance. Conclusion 2 months before surgery received GnRHa adjuvant therapy for uterine myoma, can significantly reduce the tumor volume, increased Hb level of patients, reduce the difficulty of operation, the uterine volume of more than 14 weeks of pregnancy myoma can complete laparoscopic operation possible.