腹腔镜手术联合促性腺激素释放激素激动剂治疗中、重度内异症的疗效研究 |
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引用本文: | 王博,朱定,王静云,邹放军. 腹腔镜手术联合促性腺激素释放激素激动剂治疗中、重度内异症的疗效研究[J]. 医学临床研究, 2014, 0(8): 1578-1580 |
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作者姓名: | 王博 朱定 王静云 邹放军 |
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作者单位: | 王博 (湖南省人民医院妇科,湖南 长沙,410005); 朱定 (湖南省人民医院妇科,湖南 长沙,410005); 王静云 (湖南省人民医院妇科,湖南 长沙,410005); 邹放军 (湖南省人民医院妇科,湖南 长沙,410005); |
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摘 要: | 【目的】探讨腹腔镜手术联合促性腺激素释放激素激动剂(GnRH-a)治疗中、重度子宫内膜异位症(内异症)的临床疗效。【方法】回顾性分析湖南省人民医院2010年3月至2013年3月收治的50例内异症患者临床资料。根据手术前后联合使用GnRH-a情况分为A和B两组。术前术后联合治疗组(A组):15例,腹腔镜手术前皮下注射GnRH-a共2~3次,术后再注射3次;术后联合治疗组(B组):35例,腹腔镜手术后皮下注射GnRH-a共3-6次。术后所有患者随访12个月。比较两组患者的手术时间、术中出血量、术后恢复情况、疼痛症状视觉模拟评分(VAS)、复发率及药物不良反应等指标。【结果】A组与B组手术时间分别为(65±12)min、(92±16)min;术中出血量分别为(105±12)mL、(190±29)mL ;A组患者术后下床活动时间及肛门排气时间均早于B组;治疗后随访至术后12个月,A组和B组VAS分别由术前3.7(1.7~6.5)分、3.2(1.4~6.4)分下降至1.6(1.0~3.6)分、1.6(1.1~3.5)分,A组和B组患者随访期间复发率分别为7%(1/15)、6%(2/35),两治疗组之间比较无统计学意义。【结论】腹腔镜手术联合术前术后使用GnRH-a治疗中、重度内异症能够缩短手术时间、减少术中失血、促进术后恢复;但是,与术后联合使用GnRH-a在改善术后痛经、降低复发率方面效果相当。
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关 键 词: | 腹腔镜检查 促性腺素释放激素/激动剂 促性腺素释放激素/治疗应用 子宫内膜异位症/治疗 治疗结果 回顾性研究 |
Study on the Efficacy of Laparoscopic Combined with Gonadotropin Releasing Hormone Agonist for the Treat-ment of Moderate or Severe Endometriosis |
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Affiliation: | WANG Bo, ZHU Ding, WANG J ing-yun, et al ( Department of Gynecology, Hunan Provincial People's Hospital, Changsha 410005, China ) |
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Abstract: | [Objective]To explore clinical efficacy of laparoscopy combined with gonadotropin-releasing hormone agonists (GnRH-a) for the treatment of moderate or severe endometriosis .[Methods]Clinical data of 50 patients with endometriosis in Hunan provincial people's hospital from Mar .2010 to March 2013 were analyzed retrospectively .According to the treatment methods ,all patients were divided into group A and group B .Preoperative combined with postoperative treatment group (group A ,n=15) was given subcutaneous injection with GnRH-a for 2~3 times before laparoscopy and re-injection for 3 times after laparoscopy .Postoperative treatment group(group B ,n =35) was given subcutaneous injection with GnRH-a for 3~6 times after laparoscopy .All patients were followed up for 12 months after operation .Operation time ,intraoperative blood loss ,postoperative recovery ,pain symptom visual analog scale (VAS ) ,recurrence and adverse reaction were compared between two groups .[Results] The operation time in group A and group B were (65 ± 12)min and (92 ± 16)min ,respectively .The amount of bleeding in group A and group B were (105 ± 12)mL and (190 ± 29)ml ,respectively .The time of out-of-bed activity and anus exhaust time in group A after operation were earlier than those in group B .The VAS scores in group A and group B at 12-month follow up after operation were decreased from preoperative 3 .7(1 .7~6 .5) and 3 .2(1 .4~6 .4) points to 1 .6(1 .0~3 .6) and 1 .6(1 .1~3 .5) points ,respectively .The recurrence rates in group A and group during follow up were 7% (1/15) and 6%(2/35) ,respectively .There was no significant difference between two groups .[Conclusion] Laparoscopy combined with preoperative and postoperative GnRH-a therapy for the treatment of moderate or severe endometriosis can shorten the operation time ,decrease intraoperative blood loss and promote postoperative recovery .However ,laparoscopy combined with preoperative and postoperative Gn |
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Keywords: | Laparoscopy Gonadotropin-Releasing Hormone/AG Gonadotropin-Releasing Hormone/TU Endo-metriosis/TH Treatment Outcome Retrospective Studies |
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