[Value of using gonadotropin-releasing hormone agonist pretreatment in adenomyosis patients before adenomyomectomy].

子宫腺肌病病灶切除术前使用GnRH-a预处理的价值 Value of using gonadotropin-releasing hormone agonist pretreatment in adenomyosis patients before adenomyomectomy 摘要目的：探讨子宫腺肌病病灶切除术前使用促性腺激素释放激素激动剂（GnRH-a）预处理的价值。方法选取2012年5月至2015年9月在武汉大学人民医院因保守治疗无效行子宫腺肌病病灶切除术的患者87例，按照随机数字表法，分为治疗组41例、对照组46例，治疗组术前注射GnRH-a 2～3个周期后再行手术，对照组直接手术，对比两组患者术中失血量、穿透宫腔的比例、手术时长、术后腹腔引流时间及引流液总量、手术前后血红蛋白含量差值、术后外周血白细胞总数、围手术期输血的比例、住院天数及子宫最大径差值等指标。结果治疗组患者注射GnRH-a前、后子宫最大径、血红蛋白含量及CA125水平均有明显差异（P均<0.05）；治疗组中注射GnRH-a 2个周期与3个周期者的血红蛋白含量[（108±20）、（118±24）g/L]及CA125水平[（26±11）、（19±4）kU/L]比较有明显有差异（P<0.05）。治疗组与对照组患者的术中失血量[（113±32）、（194±42）ml]、穿透宫腔的比例[12%（5/41）、12%（8/46）]、手术时长[（79±23）、（91±25）min]、术后腹腔引流时间[（2.1±0.9）、（3.0±1.2）d]及引流液总量[（152±4）、（232±32）ml]、手术前后血红蛋白含量差值[（－15.6±2.9）、（－23.7±3.5）g/L]、术后外周血白细胞总数[（11.4±4.2）×109个/L、（13.5±3.2）×109个/L]、围手术期输血的比例[5%（2/41）、20%（9/46）]、住院天数[（11.2±1.9）、（13.6±3.1）d]分别比较，差异均有统计学意义（P<0.05）。结论子宫腺肌病病灶切除术患者术前使用GnRH-a预处理有利于手术实施，可减少术中、术后并发症。 更多相关知识 abstractsObjective To investigate the value of using gonadotropin-releasing hormone agonist (GnRH-a) pretreatment in adenomyosis patients before adenomyomectomy. Methods From May 2012 to September 2015, 87 patients with adenomyosis who were non-effective to conservative therapy in Renmin Hospital of Wuhan University were enrolled in this study. According to the principle of randomized control, 41 patients were in the treatment group who were treated with GnRH-a 2-3 cycles before adenomyomectomy, while 46 patients in the control group. The control group paients were operated without any pretreatments. The blood loss, the number of penetrating into uterine cavity, duration of operation, duation of peritoneal drainage and the amount of drainage fluid, the difference of hemoglobin value before and after operation, total white blood cell count, duration of hospitalization, the maximum diameter of uterus and other indicators between the two groups were compared. Results In the treatment group, before and after treatment with GnRH-a, the uterus size, blood hemoglobinand CA125 value were statistically different (all P<0.05);between the treatment group of GnRH-a treated for 2 cycles and for 3 cycles, there were statistical differences of blood hemoglobin value [(108 ± 20) versus (118 ± 24) g/L], CA125 value [(26 ± 11) versus(19 ± 4) kU/L; all P<0.05]. There were statistical differences of blood loss in operation [(113 ± 32) versus (194 ± 42) ml], ratio of penetrating into uterine cavity [12%(5/41) versus 12%(8/46)], duration of operation[(79±23) versus (91±25) minutes], duration of peritoneal drainage after operation [(2.1±0.9) versus (3.0±1.2) days] and the amount of drainage fluid [(152±43) versus (232±32) ml], the difference of hemoglobin value before and after surgery [(-15.6±2.9) versus (-23.7±3.5) g/L], white blood cell count after 2-3 days of operation [(11.4±4.2)×109/L versus (13.5 ± 3.2) × 109/L], ratio of peri-operative blood transfusion [5% (2/41) versus 20% (9/46)] and duration of hospitalization [(11.2±1.9) versus (13.6±3.1) days] between the treatment group and the control group (all P<0.05). Conclusion The pretreatment of using GnRH-a before adenomyomectomy in adenomyosis patients has benefits for implementation of surgery and reducing peri-operative and postoperative complications. More相关知识 - 浏览724 - 被引23 - 下载261 相似文献 - 中文期刊 - 外文期刊 - 学位论文 - 会议论文