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目的探讨GnRH-a联合宫腔镜电切术治疗子宫黏膜下肌瘤的临床效果。方法选取2015年1月-2016年6月就诊于兴宁市人民医院妇科行宫腔镜下子宫黏膜下肌瘤电切术的患者60例随机分为术前GnRH-a预处理组(予2次GnRH-a预处理后再进行手术)和对照组(入选后直接进行手术)各30例,对比两组患者手术时间、术中出血量、术中灌注液使用量、术中并发症、术中肌瘤完全切除率、术者对手术的难易程度及满意程度的VSA评分等指标的差异;术后3个月和6个月进行随访,比较两组患者术后复发率、症状改善率的差异。结果与对照组比较,术前予GnRH-a预处理组患者可缩短手术时间、减少术中灌注液使用量、降低手术难度、降低术中并发症发生率和术后复发率,两组差异均有统计学意义(P<0.05);GnRH-a预处理组和对照组患者术中肌瘤完全切除率、术后6个月异常阴道流血症状的改善率差异无统计学意义(P>0.05)。结论术前GnRH-a预处理可在保证临床疗效的前提下降低宫腔镜电切术治疗子宫黏膜下肌瘤的手术难度,减少手术并发症的发生。
Objective To investigate the clinical effect of GnRH-a combined with hysteroscopic electrotomy for the treatment of uterine submucous myoma. Methods Sixty patients with hysteroscopic uterine myomectomy underwent hysteroscopic gynecological surgery at Xingning People’s Hospital from January 2015 to June 2016 were randomly divided into two groups: pre-treatment with GnRH-a GnRH-a pretreatment before surgery) and control group (directly after surgery) 30 cases of each group, compared the operation time, blood loss, intraoperative perfusion fluid usage, intraoperative complications, intraoperative Fibroids complete resection rate, the surgeon’s degree of surgical difficulty and the degree of satisfaction with the VSA score and other indicators of differences; 3 months and 6 months after follow-up, comparison of the two groups of patients the recurrence rate, the rate of improvement of symptoms difference. Results Compared with the control group, preoperative GnRH-a pretreatment group patients can shorten the operation time, reduce the amount of intraoperative perfusion, reduce the difficulty of surgery, reduce the incidence of postoperative complications and postoperative recurrence, both differences were (P <0.05). There was no significant difference in the rate of complete myomectomy and the rate of improvement of abnormal vaginal bleeding at 6 months after GnRH-a pretreatment and control (P> 0.05) . Conclusions Preoperative GnRH-a pretreatment can reduce the difficulty of hysteroscopic electrosurgical treatment of uterine submucosal fibroids under the premise of ensuring clinical efficacy, and reduce the incidence of surgical complications.