摘要
目的从增加腹膜纤溶活性方面探讨促性腺激素释放激素激动剂防止子宫肌瘤切除术后粘连形成的临床效果。方法选取2017年1月至2018年12月深圳市宝安区松岗人民医院诊治的120例子宫肌瘤患者作为研究对象。采用随机数字法将其平均分为三组,分别采取单纯腹腔镜子宫肌瘤剔除术治疗(对照组,n=40)、腹腔镜子宫肌瘤剔除术联合低剂量促性腺激素释放激素激动剂治疗(低剂量组,n=40)、腹腔镜子宫肌瘤剔除术联合高剂量促性腺激素释放激素激动剂治疗(高剂量组,n=40)。比较三组患者手术相关指标、治疗效果及不良反应发生情况。比较三组患者术后发生宫腔粘连发生情况,并进一步分析发生宫腔粘连与未发生宫腔粘连患者宫腔分泌物中TGF-β1、MMP-9表达水平。结果术后6个月,低剂量组、高剂量组患者子宫体积、肌瘤体积小于对照组,高剂量组小于低剂量组患者,差异均具有统计学意义(均P<0.05)。术后6个月,低剂量组、高剂量组患者平均经期、经量评分低于对照组患者,且高剂量组患者低于低剂量组患者,差异均具有统计学意义(均P<0.05)。术后6个月内,三组患者切口感染、腹胀、尿频、腹痛等不良反应发生率比较,差异无统计学意义(P>0.05)。术后6个月,低剂量组、高剂量组患者宫腔粘连发生率低于对照组患者,高剂量组患者低于低剂量组患者,差异具有统计学意义(P<0.05)。与未发生宫腔粘连患者比较,宫腔粘连患者宫腔分泌物中TGF-β1水平升高、MMP-9水平降低,差异均具有统计学意义(均P<0.05)。结论促性腺激素释放激素激动剂可有效防止子宫肌瘤切除术后粘连形成,分析其机制可能与增加腹膜纤溶活性相关。
Objective To investigate the clinical effect of gonadotropin releasing hormone agonists on preventing adhesion after hysteromyomectomy by increasing peritoneal fibrinolytic activity.Methods Choose between January 2017 to December 2018,in Songgang people's Hospital,Baoan District during the period of 120 patients with uterine fibroids as the research object,its average can be divided into 3 groups by random number method,respectively adopt pure laparoscopic uterine myoma eliminating treatment(control group,n=40),laparoscopic uterine fibroids rejecting technique in combination with low dose of gonadotropin-releasing hormone agonist treatment(low dose group,n=40),laparo-scopic uterine fibroids rejecting technique in combination with high dose of gonadotropin-releasing hormone agonist treat-ment(high dose group,n=40).The surgical related indicators,treatment effects and adverse reactions were compared between the three groups.The incidence of intrauterine adhesions was compared between the three groups,and the expression levels of TGF-β1 and MMP-9 in uterine secretions of patients with intrauterine adhesions and no intrauterine adhesions were further analyzed.Results Six months after operation,the uterine volume and myoma volume of the low-dose and high-dose groups were smaller than those of the control group,and those of the high-dose group were smaller than those of the low-dose group(all P<0.05).Six months after operation,the average menstrual period and menstrual volume score of the low dose and high dose groups were lower than those of the control group(all P<0.05),and that of the high dose group was lower than that of the low dose group(P<0.05).Within 6 months after operation,there was no significant difference in incision infection,abdominal distension,frequency of urination,abdominal pain and other adverse reactions among the three groups(P>0.05).Six months after operation,the incidence of intrauterine adhesions in low-dose and high-dose groups was lower than that in control group,and that in high-dose group
作者
李日红
陈光元
谢家滨
LI Rihong;CHEN Guangyuan;XIE Jiabin(Department of Gynaecology,Songgang People's Hospital,Baoan District,Shenzhen 518105,Guangdong,China)
出处
《中国性科学》
2020年第9期108-112,共5页
Chinese Journal of Human Sexuality
基金
深圳市宝安区科技计划社会公益项目(2014305)。
