【摘要】：目的:比較腹腔鏡下子宮腺肌瘤局灶切除術與術后聯(lián)合促性腺激素釋放激素激動劑(GnRH-a)在子宮腺肌瘤合并不孕癥患者治療中的效果。方法:根據(jù)治療方法的不同將研究對象分為兩組:行腹腔鏡下子宮腺肌瘤局灶切除術聯(lián)合GnRH-a治療者為研究組(72例),僅行腹腔鏡下局灶切除術為對照組(70例)。分別于術后6個月、12個月、24個月進行電話隨訪,比較兩組患者妊娠率、痛經(jīng)癥狀緩解及子宮腺肌病復發(fā)情況。結(jié)果:研究組術后24個月累計妊娠率(27.78%)高于對照組(12.86%),差異有統(tǒng)計學意義(P0.05)。研究組和對照組患者術后痛經(jīng)緩解有效率分別為86.11%、81.43%,差異無統(tǒng)計學意義(P0.05)。2年隨訪期間研究組復發(fā)率(8.33%)低于對照組(18.57%),差異有統(tǒng)計學意義(P0.05)。結(jié)論:腹腔鏡下局灶切除術后聯(lián)合GnRH-a藥物治療可以改善子宮腺肌病患者的痛經(jīng)癥狀,與單純行腹腔鏡下局灶切除術相比,聯(lián)合治療的妊娠率更高,短期內(nèi)降低復發(fā)。
[Abstract]:Objective: to compare the effect of laparoscopic focal hysterectomy and postoperative combined gonadotropin releasing hormone agonist (GnRH-a) in the treatment of uterine adenomyoma with infertility. Methods: according to the different treatment methods, the subjects were divided into two groups: the study group (72 cases) treated with local hysterectomy combined with GnRH-a, and the control group (70 cases). The pregnancy rate, dysmenorrhea symptom relief and recrudescence of adenomyosis were compared between the two groups by telephone follow-up at 6 months, 12 months and 24 months after operation. Results: the cumulative pregnancy rate (27.78%) in the study group was significantly higher than that in the control group (12.86%) (P0.05). The effective rate of postoperative dysmenorrhea relief in the study group and the control group was 86.11 and 81.43 respectively (P0.05). The recurrence rate in the study group (8.33%) was lower than that in the control group (18.57%) during the 2-year follow-up (P0.05). Conclusion: combined treatment with GnRH-a after local laparoscopic resection can improve dysmenorrhea symptoms in patients with adenomyosis. Compared with local resection under laparoscopy, the pregnancy rate of combined therapy is higher and the recurrence is decreased in the short term.
【作者單位】： 四川大學華西第二醫(yī)院出生缺陷與相關婦兒疾病教育部重點實驗室;
【分類號】：R737.33

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