促性腺激素释放激素激动剂(GnRH-a)联合腹腔镜治疗巨大子宫肌瘤的疗效评价

Curative Effect Evaluation of Gonadotropin-releasing Hormone Agonist(Gnrh-A)Combined with Laparoscopy in Treatment of Giant Uterine Fibroids

目的观察促性腺激素释放激素激动剂(GnRH-a)联合腹腔镜对巨大子宫肌瘤患者的治疗效果。方法选取2021年1月-2022年6月本院纳入的150例巨大子宫肌瘤病例,依患者治疗方案的不同分为对照组和观察组,每组各75例,对照组单用腹腔镜下子宫肌瘤剔除术(LM),观察组联合应用GnRH-a及LM术,对比两组病例的围术期相关观察指标、疾病复发情况及不良反应发生情况。结果观察组术前子宫肌瘤直径、术前子宫体积小于对照组,术前血红蛋白水平、术中出血量低于对照组,手术时间、术后盆腔引流时间、术后首次下床活动时间以及住院时间均短于对照组,组间差异有统计学意义(P<0.05);术后6个月的疾病复发率对比,组间差异无统计学意义(P>0.05);术后1年及术后2年的疾病复发率对比,观察组低于对照组(P<0.05);观察组发生烦躁/盗汗/失眠、四肢酸痛、闭经不良反应的概率比对照组更高(P<0.05)。结论对巨大子宫肌瘤患者应用Gn RH-a及LM术进行治疗更利于缩短手术时长、减少术中出血量、促进机体恢复健康并提升其远期疗效,值得推广。

Objective To observe curative effect of gonadotropin releasing hormone agonist(GnRH-a)combined with laparoscopy on patients with giant uterine fibroids.Methods The paper chose 150 cases giant uterine fibroids admitted to our hospital from January 2021 to June 2022,and divided them into control group and observation group based on different treatment schemes,75 cases in each group.Control group was treated with laparoscopic uterine fibroidectomy(LM)only,while observation group with GnRH-a and LM surgery in combination.Perioperative observation indicators,disease recurrence,and adverse reactions between two groups were compared.Results Preoperative uterine fibroid diameter and preoperative uterine volume in observation group was less than control group,while preoperative hemoglobin levels and intraoperative blood output were lower than control group.Surgical time,postoperative pelvic drainage time,postoperative first time out of bed activity,and length of stay was shorter than control group,difference between the groups was statistically significant(P<0.05).There was no statistically significant difference in disease recurrence rate between groups at 6 months after surgery(P>0.05).Comparison showed,disease recurrence rates of observation group at 1 year and 2 years after surgery were lower than control group(P<0.05).Incidence of restlessness/night sweating/insomnia,limb soreness,and amenor rhea adverse reactions in observation group was higher than control group(P<0.05).Conclusion GnRH-a and LM surgery is conducive to shortening surgical duration,reducing intraoperative bleeding for giant uterine fibroids,promoting recovery of body health,and improving long-term effect,which is worthy of promotion.