本文選題：肌壁大部切除-子宮重建術(shù) + 曼月樂��； 參考：《遵義醫(yī)學(xué)院》2014年碩士論文

【摘要】：目的:研究肌壁大部切除-子宮重建術(shù)（major uterine wall resection and reconstructionof the uterus, MURU）聯(lián)合曼月樂（Mirena, levonorgestrel-releasing intrauterine system,LNG-IUS）治療子宮腺肌�。╝denomyosis,AMS）的安全性及療效，為子宮腺肌病分度及按分度選擇治療方案的設(shè)想和保留子宮的治療目的提供依據(jù)。 方法：根據(jù)超聲子宮單側(cè)肌壁厚度（前壁、后壁或?qū)m底）或腺肌瘤最大直徑將子宮腺肌病分為輕、中、重三度。對70例中、重度腺肌癥患者行MURU術(shù)并于術(shù)中放置曼月樂，記錄MURU的手術(shù)時間、術(shù)中出血量、切除病灶（肌壁）重量、體積及治療后3個月、12個月及18個月病人痛經(jīng)程度、經(jīng)量、子宮體積、CA125，，并與術(shù)前比較，評估MURU手術(shù)的安全性及MURU+曼月樂治療腺肌病的臨床療效。 結(jié)果：70例病人MURU術(shù)均獲成功，平均手術(shù)時間、出血量、住院時間分別為（143.76±27.00）min、（52.39±14.79）ml、4.60±0.57d。術(shù)前子宮平均體積267.57±107.18cm3，切除子宮肌壁的平均重量、平均體積分別為310.35±71.26g、214.63±106.15cm3，與正常育齡婦女子宮比較，MURU術(shù)后子宮體積平均縮小3.42倍；切除肌壁的重量為正常子宮重量的5.17倍。治療后3個月、12個月和18個月的痛經(jīng)評分、經(jīng)量評分、子宮體積、CA125均顯著低于術(shù)前水平（P0.05）。所有接受MURU+曼月樂治療的患者經(jīng)術(shù)后密切隨訪至今，均無曼月樂脫落、嵌頓或異位發(fā)生，均未出現(xiàn)肥胖、脫發(fā)、潮熱、陰道干澀、性交痛等不適。 結(jié)論: MURU手術(shù)是安全的。MURU聯(lián)合曼月樂治療中、重度子宮腺肌病的療效非常顯著。
[Abstract]:Objective: to study the safety and efficacy of major uterine wall resection and reconstructionof the uterus, MURU) combined with levonorgestrel-releasing intrauterine system LNG-IUSin the treatment of adenomyosis. To provide the basis for the classification of adenomyosis and the selection of the treatment scheme according to the grading and the purpose of the treatment of uterine preservation. Methods: according to the thickness of unilateral uterine wall (anterior wall, posterior wall or uterine floor) or the maximum diameter of adenomyoma, adenomyosis was divided into three degrees: mild, moderate and severe. MURU was performed in 70 patients with severe adenomyosis. The time of MURU operation, the amount of intraoperative bleeding, the weight of lesion (muscle wall), the volume and the degree of dysmenorrhea were recorded, including 3 months, 12 months and 18 months after treatment. To evaluate the safety of MURU operation and the clinical effect of MURU manyue in the treatment of adenomyosis. Results the MURU procedure was successful in 70 patients. The average operation time, blood loss and hospitalization time were 52.39 鹵14.79 ml / min and 4.60 鹵0.57 days, respectively. The mean volume of uterus was 267.57 鹵107.18 cm ~ (3) before operation, and the mean weight of muscle wall was 310.35 鹵71.26 g / g ~ (214.63 鹵106.15) cm ~ (3), which was 3.42 times smaller than that of normal womb and 5.17 times of normal uterus. After 3 months, 12 months and 18 months of treatment, the score of dysmenorrhea and the volume of uterine volume CA125 were significantly lower than the preoperative level of P0. 05%. All the patients who received MURU Manyue were followed up closely after the operation. No Manyue shedding, incarceration or ectopic, no obesity, alopecia, hot flashes, dry vagina, intercourse pain and other discomfort. Conclusion: MURU is a safe and effective method in the treatment of severe adenomyosis.
【學(xué)位授予單位】：遵義醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R711.71

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