腹腔镜切除术联合左炔诺孕酮宫内缓释系统治疗子宫腺肌症的临床效果
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摘要
目的探讨腹腔镜切除术联合左炔诺孕酮宫内缓释系统治疗子宫腺肌症的效果。方法选取2016年6月～2017年6月我院收治的94例子宫腺肌症患者作为研究对象,采用随机数字表法分为试验组和参照组,每组各47例。参照组患者采用腹腔镜切除术治疗,试验组患者则在腹腔镜切除术后在宫腔内置入左炔诺孕酮宫内缓释系统进行联合治疗。观察比较两组患者治疗前后的痛经程度、月经量以及血红蛋白的变化情况,并分析两组患者子宫腺肌症1年内的复发情况。结果治疗前,两组患者痛经程度的视觉模拟量表(VAS)评分、月经量的月经失血图(PBAC)评分以及血红蛋白等指标比较,差异无统计学意义(P>0.05)。治疗后,两组患者的痛经程度VAS评分、月经量PBAC评分以及血红蛋白均有不同程度的改善(P<0.05),而试验组患者治疗后的痛经程度VAS评分、月经量PBAC评分均低于参照组,血红蛋白则高于参照组,差异有统计学意义(P<0.05)。试验组患者1年内的复发率为0.00%,低于参照组的12.77%,差异有统计学意义(P<0.05)。结论子宫腺肌症患者应用腹腔镜切除术联合左炔诺孕酮宫内缓释系统治疗能提高临床效果,可以有效改善患者的痛经和贫血症状,促进其月经量恢复正常,减少术后复发,值得临床进一步推广应用。
Objective To investigate the effect of laparoscopic resection combined with Levonorgestrel intrauterine sustained-release system in the treatment of adenomyosis. Methods From June 2016 to June 2017, 94 patients with adenomyosis in our hospital were selected as the research objects. The patients were divided into the experimental group and the control group by random number table method, with 47 patients in each group. Patients in the control group were treated by laparoscopic resection, while patients in the experimental group were treated with Levonorgestrel intrauterine sustained-release system after laparoscopic resection. The changes of dysmenorrhea, menstrual volume and hemoglobin before and after treatment were observed and compared between the two groups. The recurrence of adenomyosis in two groups within 1 year was analyzed. Results Before treatment, there were no significant differences in visual analogue score(VAS) of dysmenorrhea degree, pictorial blood loss assessment chart(PBAC) score and hemoglobin score of dysmenorrhea between the two groups(P>0.05). After treatment, the VAS score of dysmenorrhea degree, PBAC score and hemoglobin score of dysmenorrhea degree were improved in both groups(P<0.05), while the VAS score and PBAC score of menstrual volume in the experimental group were lower than those in the control group, and the hemoglobin level in the experimental group was significantly higher than that in the control group, the differences were statistically significant(P<0.05). The recurrence rate of the patients in the experimental group was 0.00%, which was lower than that in the control group(12.77%), and the difference was statistically significant(P<0.05). Conclusion The laparoscopic resection combined with Levonorgestrel intrauterine sustained-release system can improve the clinical treatment effect, improve dysmenorrhea and anemia symptoms, promote the return of menstrual volume to normal, and reduce postoperative recurrence, which is worthy of further clinical application.
Objective To investigate the effect of laparoscopic resection combined with Levonorgestrel intrauterine sustained-release system in the treatment of adenomyosis. Methods From June 2016 to June 2017, 94 patients with adenomyosis in our hospital were selected as the research objects. The patients were divided into the experimental group and the control group by random number table method, with 47 patients in each group. Patients in the control group were treated by laparoscopic resection, while patients in the experimental group were treated with Levonorgestrel intrauterine sustained-release system after laparoscopic resection. The changes of dysmenorrhea, menstrual volume and hemoglobin before and after treatment were observed and compared between the two groups. The recurrence of adenomyosis in two groups within 1 year was analyzed. Results Before treatment, there were no significant differences in visual analogue score(VAS) of dysmenorrhea degree, pictorial blood loss assessment chart(PBAC) score and hemoglobin score of dysmenorrhea between the two groups(P>0.05). After treatment, the VAS score of dysmenorrhea degree, PBAC score and hemoglobin score of dysmenorrhea degree were improved in both groups(P<0.05), while the VAS score and PBAC score of menstrual volume in the experimental group were lower than those in the control group, and the hemoglobin level in the experimental group was significantly higher than that in the control group, the differences were statistically significant(P<0.05). The recurrence rate of the patients in the experimental group was 0.00%, which was lower than that in the control group(12.77%), and the difference was statistically significant(P<0.05). Conclusion The laparoscopic resection combined with Levonorgestrel intrauterine sustained-release system can improve the clinical treatment effect, improve dysmenorrhea and anemia symptoms, promote the return of menstrual volume to normal, and reduce postoperative recurrence, which is worthy of further clinical application.
引文
[1]武继平,杨春艳,温丽,等.子宫动脉栓塞术联合宫腔放置左炔诺孕酮宫内缓释系统治疗子宫腺肌症及子宫腺肌瘤的临床观察[J].山西医药杂志,2013,42(14):790-791.
[2]徐静.腹腔镜切除术联合左炔诺孕酮宫内缓释系统对子宫腺肌症的治疗效果观察[J].国际医药卫生导报,2017,23(9):1360-1363.
[3]高彦荣,张晓婷.腹腔镜联合左炔诺孕酮宫内缓释系统治疗子宫内膜异位症的护理[J].护理学杂志,2013,28(12):34-35.
[4]黄吕成,王爱敏,张潍.两种左炔诺孕酮宫内缓释系统放置方案辅助腹腔镜手术治疗子宫腺肌症的临床对比研究[J].河北医药,2017,39(1):100-101.
[5]赵蓉,王丽梅,顾玉婵,等.腹腔镜病灶切除术联合左炔诺孕酮宫内缓释系统治疗子宫腺肌症的疗效观察[J].中国妇产科临床杂志,2016,17(1):24.
[6]马宏龙.腹腔镜切除病灶联合曼月乐治疗子宫腺肌症的效果及对卵巢功能的影响[J].中国妇幼保健,2017,32(18):75-78.
[7]陈玉环,李静文,姚恒,等.子宫动脉栓塞术联合左炔诺孕酮宫内缓释系统治疗子宫腺肌症的临床研究[J].中华全科医学,2017,15(11):1904-1906.
[8]王静,罗小琼,陈升才,等.腹腔镜子宫动脉阻断术联合放置左炔诺孕酮宫内缓释系统治疗子宫腺肌病的临床效果分析[J].右江民族医学院学报,2015,37(6):803-804.
[9]张彩玩,邓森灵.子宫腺肌病患者应用腹腔镜子宫楔形切除术并术后阴道置放左炔诺孕酮宫内缓释系统治疗效果观察[J].中国性科学,2018,22(4):34-36.
[10]金平安,尹庆卿.左炔诺孕酮宫内缓释系统治疗子宫腺肌症的疗效及安全性观察[J].中国性科学,2015,30(1):39-41.
[11]逯蓓蓓.观察子宫腺肌瘤局部病灶切除术治疗子宫腺肌症的临床效果[J].深圳中西医结合杂志,2017,27(1):148-149.
[12]李英惠,陈丽,杜润青.左炔诺孕酮宫内缓释系统治疗子宫腺肌症月经过多的临床观察[J].河北医药,2014,20(23):3606-3607.
[13]杨娟.腹腔镜子宫切除术治疗子宫腺肌症的临床疗效分析[J].中国卫生标准管理,2016,7(17):42-43.
[14]李亚军,李文影,秦文芝,等.腹腔镜子宫腺肌症病灶切除术联合促性腺激素释放激素激动剂治疗子宫腺肌症临床效果分析[J].中国医药,2014,9(10):1542-1546.
[15]王志平.腹腔镜病灶切除术联合左炔诺孕酮宫内缓释系统对子宫腺肌症的疗效观察[J].河南医学研究,2018,21(8):167-168.
[2]徐静.腹腔镜切除术联合左炔诺孕酮宫内缓释系统对子宫腺肌症的治疗效果观察[J].国际医药卫生导报,2017,23(9):1360-1363.
[3]高彦荣,张晓婷.腹腔镜联合左炔诺孕酮宫内缓释系统治疗子宫内膜异位症的护理[J].护理学杂志,2013,28(12):34-35.
[4]黄吕成,王爱敏,张潍.两种左炔诺孕酮宫内缓释系统放置方案辅助腹腔镜手术治疗子宫腺肌症的临床对比研究[J].河北医药,2017,39(1):100-101.
[5]赵蓉,王丽梅,顾玉婵,等.腹腔镜病灶切除术联合左炔诺孕酮宫内缓释系统治疗子宫腺肌症的疗效观察[J].中国妇产科临床杂志,2016,17(1):24.
[6]马宏龙.腹腔镜切除病灶联合曼月乐治疗子宫腺肌症的效果及对卵巢功能的影响[J].中国妇幼保健,2017,32(18):75-78.
[7]陈玉环,李静文,姚恒,等.子宫动脉栓塞术联合左炔诺孕酮宫内缓释系统治疗子宫腺肌症的临床研究[J].中华全科医学,2017,15(11):1904-1906.
[8]王静,罗小琼,陈升才,等.腹腔镜子宫动脉阻断术联合放置左炔诺孕酮宫内缓释系统治疗子宫腺肌病的临床效果分析[J].右江民族医学院学报,2015,37(6):803-804.
[9]张彩玩,邓森灵.子宫腺肌病患者应用腹腔镜子宫楔形切除术并术后阴道置放左炔诺孕酮宫内缓释系统治疗效果观察[J].中国性科学,2018,22(4):34-36.
[10]金平安,尹庆卿.左炔诺孕酮宫内缓释系统治疗子宫腺肌症的疗效及安全性观察[J].中国性科学,2015,30(1):39-41.
[11]逯蓓蓓.观察子宫腺肌瘤局部病灶切除术治疗子宫腺肌症的临床效果[J].深圳中西医结合杂志,2017,27(1):148-149.
[12]李英惠,陈丽,杜润青.左炔诺孕酮宫内缓释系统治疗子宫腺肌症月经过多的临床观察[J].河北医药,2014,20(23):3606-3607.
[13]杨娟.腹腔镜子宫切除术治疗子宫腺肌症的临床疗效分析[J].中国卫生标准管理,2016,7(17):42-43.
[14]李亚军,李文影,秦文芝,等.腹腔镜子宫腺肌症病灶切除术联合促性腺激素释放激素激动剂治疗子宫腺肌症临床效果分析[J].中国医药,2014,9(10):1542-1546.
[15]王志平.腹腔镜病灶切除术联合左炔诺孕酮宫内缓释系统对子宫腺肌症的疗效观察[J].河南医学研究,2018,21(8):167-168.