腹腔镜子宫动脉阻断加子宫腺肌瘤切除合并曼月乐治疗子宫腺肌瘤临床分析

［摘要］目的 观察腹腔镜子宫动脉阻断加子宫腺肌瘤切除合并曼月乐治疗子宫腺肌瘤的效果及其对卵巢功能的影响。方法 选择子宫腺肌瘤患者130例，随机分为观察组和对照组各65例。对照组给予米非司酮治疗，观察组给予曼月乐治疗。观察2组临床疗效和总有效率，比较2组子宫体积、宫腔大小和糖抗原125（carbohydrate antigen 125，CA125)水平，比较2组治疗前后月经变化和卵巢功能变化以及不良反应发生率。结果 观察组临床疗效和总有效率均高于对照组（P＜0.05）；治疗后2组子宫体积、宫腔大小和CA125水平均较治疗前明显缩小或降低（P＜0.05）,观察组缩小或降低的幅度更大，治疗后观察组子宫体积、宫腔大小和CA125水平均小于或低于对照组（P＜0.05）；治疗后2组月经期均明显缩短，疼痛评分均较治疗前明显降低，月经周期均较治疗前明显延长（P＜0.05），治疗后观察组疼痛评分低于对照组（P＜0.05）；治疗后2组黄体生成激素（luteinizing hormone，LH），促卵泡成熟激素（follicle-stimulating hormone，FSH）水平均较治疗前明显降低，雌二醇（estradiol，E2）水平均较治疗前明显升高（P＜0.05），治疗后观察组LH、FSH和E2水平均低于对照组（P＜0.05）；2组不良反应发生率差异无统计学意义（P＞0.05）。结论 腹腔镜子宫动脉阻断加子宫腺肌瘤切除合并曼月乐治疗子宫腺肌瘤效果显著，能够明显缓解症状和改善机体的性激素紊乱。

Clinical analysis of laparoscopic uterine artery occlusion plus uterine adenomyectomy combined with Mirena in the treatment of adenomyoma

［Abstract］ Objective To observe the efficacy of laparoscopic uterine artery occlusion plus uterine adenomyectomy combined with Mirena on uterine adenomyoma and its effect on ovarian function. Methods One hundred and thirty patients with adenomyoma were randomly divided into observation group and control group, 65 cases in each group. The control group was given Mifepristone, and the observation group was treated with Mirena. The clinical efficacy and total effective rate were observed in two groups. The uterus volume, uterine cavity size and carbohydrate antigen 125（CA125） were compared between two groups. The menstrual and ovarian function was compared before and after treatment, and the incidence of adverse reactions was compared between two groups. Results The clinical efficacy and total effective rate in observation group were higher than those in control group(P＜0.05). The uterus volume, uterine cavity size and CA125 level in two groups were significantly smaller and lower than those before treatment(P＜0.05), and the reduction and reduction in the observation group was more obvious. After treatment, the uterus volume, uterine cavity size and CA125 level in observation group were lower than those in control group(P＜0.05). After treatment, the menstrual period was significantly shortened, the pain score was significantly lower, and the menstrual cycle was significantly longer than that before treatment(P＜0.05). After treatment the pain score in observation group was lower than that of the control group(P＜0.05), the levels of luteinizing hormone（LH） and follicle-stimulating hormone（FSH） in two groups were significantly lower than those before treatment, and the estradiol（E2） level was significantly higher than that before treatment(P＜0.05). The levels of LH, FSH and E2 in the observation group were lower than those in control group(P＜0.05). There was no significant difference in the incidence of adverse reactions between two groups(P＞0.05). Conclusion Laparoscopic uterine artery occlusion plus resection of adenomyoma combined with Mirena is effective in treating adenomyoma of the uterus, which can significantly relieve symptoms and improve the body′s sex hormone disorder.