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目的:探讨腹腔镜下腺肌瘤切除术及左炔诺孕酮联合米非司酮治疗子宫腺肌病的临床效果。方法:采用随机数字表法将南华大学第一附属医院2010年3月~2014年1月收治的80例子宫腺肌病患者分为联合组(40例)和对照组(40例),两组患者均采用腹腔镜下腺肌瘤切除术结合左炔诺孕酮治疗,联合组在此基础上于术后前3个月使用米非司酮处理,比较两组患者的术后疗效。结果:联合组和对照组的手术时间、术中出血量及住院时间比较差异均无统计学意义(P>0.05);两组患者术前月经量、月经周期、月经天数、痛经程度、子宫体积、血红蛋白(Hb)、雌二醇、黄体生成素(LH)及卵泡刺激素(FSH)水平比较差异均无统计学意义(P>0.05);两组患者术后第3个月的月经量、月经周期、月经天数、痛经程度、子宫体积、Hb、雌二醇、LH及FSH水平比较差异均无统计学意义(P>0.05);术后第6个月联合组的月经量、痛经程度及子宫体积显著小于对照组(P<0.05)。结论:腹腔镜下腺肌瘤切除术及左炔诺孕酮联合米非司酮治疗子宫腺肌病对改善月经量过多、痛经及子宫恢复有显著的效果。
Objective: To investigate the clinical effect of laparoscopic adenomyctomy and levonorgestrel combined with mifepristone in the treatment of adenomyosis. Methods: A total of 80 patients with adenomyosis admitted to the First Affiliated Hospital of Nanhua University from March 2010 to January 2014 were divided into two groups: the combined group (40 cases) and the control group (40 cases) Patients were treated with laparoscopic adenomyotomy combined with levonorgestrel treatment, the combined group on the basis of this in the first 3 months after the use of mifepristone treatment, the efficacy of the two groups were compared. Results: There was no significant difference in operative time, blood loss and length of hospital stay between the two groups (P> 0.05). The preoperative menstrual flow, menstrual cycle, menstrual cycle, dysmenorrhea, uterine volume , Hemoglobin (Hb), estradiol, luteinizing hormone (LH) and follicle stimulating hormone (FSH) were not significantly different between the two groups (P> 0.05) Menstrual cycle, menstruation days, degree of dysmenorrhea, uterine volume, Hb, estradiol, LH and FSH levels were not significantly different (P> 0.05); 6 months after operation the menstrual flow, dysmenorrhea, Uterine volume was significantly smaller than the control group (P <0.05). Conclusions: Laparoscopic adenomyctomy and levonorgestrel combined with mifepristone in the treatment of adenomyosis have a significant effect on improvement of menorrhagia, dysmenorrhea and uterine recovery.