经阴道超声联合GnRH在腹腔镜子宫肌瘤剔除术中的疗效分析
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摘要
目的分析经阴道超声联合促性腺激素释放激素(GnRH)在腹腔镜子宫肌瘤剔除术中的疗效及对患者预后的影响。方法选取我院收治的100例行腹腔镜子宫肌瘤剔除术的患者,随机分为对照组和研究组。对照组采用经阴道超声法,研究组采用经阴道超声联合GnRH治疗。观察两组患者的临床治疗效果、手术情况及术后并发症。结果治疗前两组患者各项指标无明显差异(P>0.05);研究组患者的手术时间、输血例数、术中出血量以及住院时间均明显低于对照组(P<0.05);研究组患者术后24 h肠排气、膀胱、输尿管及直肠损伤、血肿和术后切口感染的发生率均显著低于对照组(P<0.05)。结论经阴道超声联合GnRH对腹腔镜子宫肌瘤剔除术的效果理想,值得临床进一步推广应用。
Objective To analyze the effects of combined use of gonadotropin releasing hormone(GnRH) and transvaginal ultrasound method on laparoscopic myomectomy and its effects on the prognosis of patients. Methods 100 cases of uterine fibroids patients in our hospital were randomly divided into control group and research group. Patients in control group got laparoscopic myomectomy with the leading of transvaginal ultrasound, and those in research group were added with GnRH therapy on the base of treatment of control group. Observe the clinical curative effect, surgery and postoperative complications. Results Before treatment, the indexes of patients had no significant difference between two groups(P>0.05). The operation time, intraoperative bleeding volume, blood transfusion cases and hospitalization time of the research group were significantly less than those of control group(P<0.05). The incidences of postoperative 24 h intestinal exhaust, injury of bladder, ureter and rectum, infection of incision hematoma and other postoperative complications were significantly lower in the research group than in the control group(P<0.05). Conclusion Transvaginal sonography combined with GnRH for hysteromyomectomy had good curative effects, and it is worthy of further clinical application.
Objective To analyze the effects of combined use of gonadotropin releasing hormone(GnRH) and transvaginal ultrasound method on laparoscopic myomectomy and its effects on the prognosis of patients. Methods 100 cases of uterine fibroids patients in our hospital were randomly divided into control group and research group. Patients in control group got laparoscopic myomectomy with the leading of transvaginal ultrasound, and those in research group were added with GnRH therapy on the base of treatment of control group. Observe the clinical curative effect, surgery and postoperative complications. Results Before treatment, the indexes of patients had no significant difference between two groups(P>0.05). The operation time, intraoperative bleeding volume, blood transfusion cases and hospitalization time of the research group were significantly less than those of control group(P<0.05). The incidences of postoperative 24 h intestinal exhaust, injury of bladder, ureter and rectum, infection of incision hematoma and other postoperative complications were significantly lower in the research group than in the control group(P<0.05). Conclusion Transvaginal sonography combined with GnRH for hysteromyomectomy had good curative effects, and it is worthy of further clinical application.
引文
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[10]Sharma A, Burnell M, Gentry-Maharaj A, et al. Quality assurance and its impact on ovarian visualization rates in the multicenter United Kingdom Collaborative Trial of Ovarian Cancer Screening(UKCTOCS)[J]. Ultrasound Obstet Gynecol, 2016, 47(2):228-235. doi:10.1002/uog.14929.
[11]Dueholm M, Christensen JW, Rydbjerg S, et al. Two-and three-dimensional transvaginal ultrasound with power Doppler angiography and gel infusion sonography for diagnosis of endometrial malignancy[J]. Ultrasound Obstet Gynecol,2015, 45(6):734-743. doi:10.1002/uog.13421.
[12]Zhang JP, Li QC, Lin CL. The Research on the Efficacy and Safety of Particles Embolization with Different Sizes for Treatment of Uterine Fibroids[J]. Anti-tumor Pharmacology, 2017, 7(5):619-622.[张建平,李青春,林春丽.采用不同大小的颗粒栓塞剂栓塞治疗子宫肌瘤的疗效及安全性研究[J].肿瘤药学, 2017, 72(5):619-622.] doi:10.3969/j. issn.2095-1264.2017.05.21.
[13]Diego R, Douet C, Reigner F, et al. Influence of transvaginal ultrasound-guided follicular punctures in the mare on heart rate, respiratory rate, facial expression changes, and salivary cortisol as pain scoring[J]. Theriogenology, 2016, 86(7):1757-1763. doi:10.1016/j. theriogenology.2016.05.040.
[14]Guo J, Wang BH, Tuoya, et al. The Preemptive Analgesia Effect of Low Dose Ketamine Combined with Lidocaine on Stress Response for Postoperative Patients with Uterine Myoma[J]. Antitumor Pharmacology, 2017, 7(2):219-223.[郭静,王炳海,托娅,等.低剂量氯胺酮联合利多卡因超前镇痛对子宫肌瘤患者术后应激反应的作用研究[J].肿瘤药学, 2017,7(2):219-223.] doi:10.3969/j. issn.2095-1264.2017.02.18.
[15]Marcellin L, Senat MV, Benachi A, et al. Impact of routine transvaginal ultrasound monitoring of cervical length in twins on administration of antenatal corticosteroids[J]. J Perinat Med, 2017, 45(4):471-477. doi:10.1515/jpm-2016-0102.
[2]Diel de Amorim M, Nairn D, Manning S, et al. Evaluation of diagnostic utility, safety considerations, and effect on fertility of transvaginal ultrasound-guided ovarian biopsy in mares[J]. Theriogenology, 2016, 85(6):1030-1036. doi:10.1016/j.theriogenology.2015.11.013.
[3]Taks?e-Vester C A, Dreisler E, Andreasen L A, et al.OP29.08:Impact of image orientation during transvaginal ultrasound training[J]. Ultrasound Obstet Gynecol, 2017,50(S1):144-145. doi:10.1002/uog.17975.
[4]Eisenberg V H, Markovitz H, Arbib N, et al. OP31.04:Evidence of adenomyosis on transvaginal ultrasound and infertility management of patients with endometriosis selected for surgical intervention[J]. Ultrasound Obstet Gynecol, 2017,50(S1):150. doi:10.1002/uog.17992.
[5]Ferrero S, Laraud F, Bondi C, et al. OC22.04:Transvaginal ultrasonography combined with computed tomographic colonography in the diagnosis of bowel endometriosis[J]. Ultrasound Obstet Gynecol, 2017, 50(S1):46. doi:10.1002/uog.17688.
[6]Kamel HS, Darwish AM, Mohamed SA. Comparison of transvaginal ultrasonography and vaginal sonohysterography in the detection of endometrial polyps[J]. Acta Obstet Gynecol Scand, 2000, 79(1):60-64.
[7]Guerriero S, Ajossa S, Orozco R, et al. Accuracy of transvaginal ultrasound for diagnosis of deep endometriosis in the rectosigmoid:systematic review and meta-analysis[J].Ultrasound Obstet Gynecol, 2016, 47(3):281-289. doi:10.1002/uog.15662.
[8]Alcázar JL, Gastón B, Navarro B, et al. Transvaginal ultrasound versus magnetic resonance imaging for preoperative assessment of myometrial infiltration in patients with endometrial cancer:a systematic review and meta-analysis[J]. J Gynecol Oncol, 2017, 28(6):e86. doi:10.3802/jgo.2017.28. e86.
[9]Guerriero S, Ajossa S, Orozco R, et al. Accuracy of transvaginal ultrasound for diagnosis of deep endometriosis in the rectosigmoid:systematic review and meta-analysis[J]. Ultrasound Obstet Gynecol, 2016, 47(3):281-289. doi:10.1002/uog.15662.
[10]Sharma A, Burnell M, Gentry-Maharaj A, et al. Quality assurance and its impact on ovarian visualization rates in the multicenter United Kingdom Collaborative Trial of Ovarian Cancer Screening(UKCTOCS)[J]. Ultrasound Obstet Gynecol, 2016, 47(2):228-235. doi:10.1002/uog.14929.
[11]Dueholm M, Christensen JW, Rydbjerg S, et al. Two-and three-dimensional transvaginal ultrasound with power Doppler angiography and gel infusion sonography for diagnosis of endometrial malignancy[J]. Ultrasound Obstet Gynecol,2015, 45(6):734-743. doi:10.1002/uog.13421.
[12]Zhang JP, Li QC, Lin CL. The Research on the Efficacy and Safety of Particles Embolization with Different Sizes for Treatment of Uterine Fibroids[J]. Anti-tumor Pharmacology, 2017, 7(5):619-622.[张建平,李青春,林春丽.采用不同大小的颗粒栓塞剂栓塞治疗子宫肌瘤的疗效及安全性研究[J].肿瘤药学, 2017, 72(5):619-622.] doi:10.3969/j. issn.2095-1264.2017.05.21.
[13]Diego R, Douet C, Reigner F, et al. Influence of transvaginal ultrasound-guided follicular punctures in the mare on heart rate, respiratory rate, facial expression changes, and salivary cortisol as pain scoring[J]. Theriogenology, 2016, 86(7):1757-1763. doi:10.1016/j. theriogenology.2016.05.040.
[14]Guo J, Wang BH, Tuoya, et al. The Preemptive Analgesia Effect of Low Dose Ketamine Combined with Lidocaine on Stress Response for Postoperative Patients with Uterine Myoma[J]. Antitumor Pharmacology, 2017, 7(2):219-223.[郭静,王炳海,托娅,等.低剂量氯胺酮联合利多卡因超前镇痛对子宫肌瘤患者术后应激反应的作用研究[J].肿瘤药学, 2017,7(2):219-223.] doi:10.3969/j. issn.2095-1264.2017.02.18.
[15]Marcellin L, Senat MV, Benachi A, et al. Impact of routine transvaginal ultrasound monitoring of cervical length in twins on administration of antenatal corticosteroids[J]. J Perinat Med, 2017, 45(4):471-477. doi:10.1515/jpm-2016-0102.