子宫肌瘤剔除术联合GnRH-a治疗弥漫性子宫平滑肌瘤病六例

Myomectomy combined with GnRH-a in treatment of diffuse uterine leiomyomatosis:analysis of 6 cases

目的探讨传统子宫肌瘤剔除术+促性腺激素释放激素激动剂(gonadotropin releasing hormone agonist,GnRH-a)治疗弥漫性子宫平滑肌瘤病的效果。方法对6例弥漫性子宫平滑肌瘤病患者采用传统的经腹子宫肌瘤剔除术,术后辅以GnRH-a治疗。对每例术中切除肌瘤个数等进行统计,并随访术后情况。结果术中平均切除肌瘤数68个(19~135个),平均出血量283 m L(100~600 m L),平均手术时间132 min(50~185 min)。所有患者术后月经恢复正常,贫血症状改善。2例成功妊娠,孕期及产后平稳,无并发症发生。结论传统子宫肌瘤剔除术+GnRH-a治疗对于希望保留生育功能的弥漫性子宫平滑肌瘤病患者可作为一种治疗选择。

Objective To analyze the efficacy of conventional myomectomy and gonadotropin releasing hormone agonist( GnRH-a) combined treatment for diffuse uterine leiomyomatosis. Methods Six cases of diffuse uterine leiomyomatosis received conventional myomectomy with GnRH-a as a postoperative adjuvant therapy. The number of myomas enucleated was analyzed and all patients were followed-up postoperatively. Results The mean number of enucleated myomas was 68( 19-135). The mean blood loss during surgery was 283 m L( 100-600 m L) and the mean operative time was 132 min( 50-185 min). Postoperatively,regular menses were restored and anemia was relieved in all cases. Two patients became pregnant,with smooth antenatal course and postnatal period without any complication. Conclusion Conventional myomectomy with GnRH-a combined treatment can be considered as an option for women with diffuse uterine leiomyomatosis who wish to preserve fertility.