子宫体积>孕14周的子宫肌瘤患者术前使用促性腺激素释放激素激动剂的疗效

Preoperative use of gonadotropin releasing hormone agonist in uterine fibroid patients with uterine volume >at 14 weeks of gestation

目的探讨子宫体积>孕14周的子宫肌瘤患者术前使用促性腺激素释放激素激动剂(gonadotropin-releasing hormone agonist, GnRHa)的疗效。方法辽宁省朝阳北票市职业病防治院妇产科2015年6月~2017年6月间80例子宫体积>孕14周子宫肌瘤患者,随机分为常规组和药物组各40例,常规组患者实施常规手术治疗,药物组患者术前使用GnRHa辅助治疗,对比两种方式的临床疗效。比较两组患者最大肌瘤体积、子宫体积、血红蛋白水平、术中出血量、手术时间、术后住院时间以及用药不良反应的差异。结果药物组患者手术前最大肌瘤体积及子宫体积低于用药前,血红蛋白水平高于用药前,差异具有统计学意义(P<0.05);药物组患者手术前最大肌瘤体积、子宫体积与手术组手术前相比下降,血红蛋白水平与手术组手术前相比升高,差异具有统计学意义(P<0.05),药物组患者术中出血量、手术时间、术后住院时间均较手术组少,且差异具有统计学意义(P<0.05)。药物组患者用药后不良反应症状较轻。结论子宫体积>孕14周的子宫肌瘤患者术前使用GnRHa可改善患者手术指标。

Objective To investigate the effect of gonadotropin releasing hormone agonist （GnRHa） on preoperative treatment of uterine fibroids with uterine volume 〉at 14 weeks of gestation. Methods From June 2015 to June 2017, 80 cases of uterine fibroids with 〉 pregnancy at 14 weeks were randomly divided into the routine group and the drug group,40 case in each group. Routine surgical treatment was performed for patients in the routine group, and GnRHa was used for preoperative adjuvant therapy for patients in the drug group. The differences of maximum fibroid volume,uterine volume, hemoglobin level, intraoperative blood loss, operation time, postoperative hospital stay and adverse drug reactions were compared between the two groups. Results The maximum fibroid volume and uterine volume of patients in the drug group were lower than those before the drug administration, and the hemoglobin level was higher than that before the drug administration, and the difference was statistically significant （P〈0.05）. Drug group of patients before surgery biggest fibroid uterine size, volume and scores drop compared to before the operation, higher hemoglodoi：bin levels compared with scores before surgery, statistically significant difference （P〈0.05）, drug group of patients with intraoperative blood loss,operative time, postoperative hospital stay were relatively less surgery group, and the difference is statistically significant （P〈0.05）. The adverse reactions were mild in the drug group. Conclusion The preoperative use of GnRHa in patients with uterine fibroids with uterine volume 〉at 14 weeks of pregnancy can improve the surgical indicators.