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目的评估促性腺激素释放激素(GnRH)激动剂治疗是否有利于腹腔镜辅助阴式手术(LAVH)切除巨大子宫,探讨临床应用价值。方法选取该院2014年1月—2016年6月收治巨大子宫(子宫体积≥12孕周)病例75例,均行腹腔镜辅助阴式子宫切除术,分为观察组36例(手术联合GnRH-a治疗)和对照组39例(单纯手术)。比较观察组GnRH-a治疗前后临床症状、血红蛋白浓度和子宫体积大小变化;比较二组手术相关指标。结果观察组GnRH-a治疗后可缩减巨大子宫体积,改善贫血,控制症状;观察组较对照组手术时间缩短,术中出血量减少,差异有统计学意义。结论对于巨大子宫病例,术前GnRH-a治疗可缩减子宫体积,减少血供,控制临床症状,降低手术难度,增加手术安全性和可靠性,具有重要的临床意义。
Objective To evaluate whether Gonadotropin-releasing hormone (GnRH) agonist treatment is beneficial to laparoscopic assisted vaginal surgery (LAVH) in the removal of giant uterus and to explore its clinical value. Methods From January 2014 to June 2016, 75 cases of giant uterus (uterine volume≥12 gestational weeks) admitted to our hospital from January 2014 to June 2016 were enrolled in this study. Laparoscopic assisted vaginal hysterectomy was performed and divided into observation group of 36 cases (operation combined with GnRH- a treatment) and control group 39 cases (simple surgery). The changes of clinical symptoms, hemoglobin concentration and uterine volume before and after GnRH-a treatment in the observation group were compared. Surgical related indexes of the two groups were compared. Results After treatment with GnRH-a, the volume of giant uterus was reduced, the anemia was improved and the symptom was controlled. The operation time of observation group was shorter than that of control group, and the amount of bleeding during operation was decreased. The difference was statistically significant. CONCLUSIONS: In the case of huge uterus, preoperative GnRH-a treatment can reduce the volume of the uterus, reduce blood supply, control clinical symptoms, reduce the difficulty of operation and increase the safety and reliability of the operation. It is of important clinical significance.