CAJ | 학술논문

目的：探讨腹腔镜子宫腺肌病病灶切除术联合促性腺激素释放激素激动剂（GnRH-a）治疗子宫腺肌病的疗效。方法回顾性分析2009年1月～2013年5月我院79例行腹腔镜子宫腺肌病病灶切除术患者的临床资料，其中手术联合药物组（A 组）42例，术后第3天皮下注射亮丙瑞林6个疗程（28天一次），单纯手术组（B 组）37例，比较2组治疗后痛经、月经量、子宫体积的变化。结果2组治疗后痛经分级降低（F ＝342．967，P ＝0．000），月经量评分降低（F ＝135．743，P ＝0．000），子宫体积缩小（F ＝393．341，P ＝0．000）。与 B 组相比，A 组痛经分级和月经量评分降低明显（F ＝14．274，P ＝0．000，F ＝18．222， P ＝0．000），子宫体积明显缩小（F ＝30．692，P ＝0．000）。随访12～64个月，（30．3±10．3）月，A 和 B 组的有效率分别为81．0％（34／42）、62．2％（21／37）（log-rank χ2＝4．915，P ＝0．027）。结论腹腔镜子宫腺肌病病灶切除联合 GnRH-a 治疗能更有效地控制患者的临床症状，减少复发。
목적：탐토복강경자궁선기병병조절제술연합촉성선격소석방격소격동제（GnRH-a）치료자궁선기병적료효。방법회고성분석2009년1월～2013년5월아원79례행복강경자궁선기병병조절제술환자적림상자료，기중수술연합약물조（A 조）42례，술후제3천피하주사량병서림6개료정（28천일차），단순수술조（B 조）37례，비교2조치료후통경、월경량、자궁체적적변화。결과2조치료후통경분급강저（F ＝342．967，P ＝0．000），월경량평분강저（F ＝135．743，P ＝0．000），자궁체적축소（F ＝393．341，P ＝0．000）。여 B 조상비，A 조통경분급화월경량평분강저명현（F ＝14．274，P ＝0．000，F ＝18．222， P ＝0．000），자궁체적명현축소（F ＝30．692，P ＝0．000）。수방12～64개월，（30．3±10．3）월，A 화 B 조적유효솔분별위81．0％（34／42）、62．2％（21／37）（log-rank χ2＝4．915，P ＝0．027）。결론복강경자궁선기병병조절제연합 GnRH-a 치료능경유효지공제환자적림상증상，감소복발。
Objective To discuss the effect of laparoscopic adenomyomectomy combined with gonadotropin-releasing hormone agonist (GnRH-a)administration in the treatment of uterine adenomyosis. Methods Clinical data of 79 patients with uterine adenomyosis from January 2009 to May 2013 were collected.The patients of group A (42 cases)were given triptorelin for 6 courses after laparoscopic adenomyomectomy,whereas the patients of group B (37 cases)underwent laparoscopic adenomyomectomy alone. The dysmenorrhea,the menstrual amount and the uterine volume were analyzed. Results After treatment,the dysmenorrhea grade, the menstrual volume score and the uterine volume of the two groups were all significantly decreased (F =342.967,P =0.000;F =135.743,P =0.000;F =393.341 ,P =0.000 ).The dysmenorrhea grade and menstrual volume score in the group A were statistically lower than those in the group B (F =14.274,P =0.000;F =18.222,P =0.000).The uterine volume in the group A was smaller than that in the group B (F =30.692,P =0.000).The effect rates of group A and group B during follow-up were 81 .0%(34 /42 ) and 62.2% (21 /37 ),respectively (χ2 =4.915,P =0.027 ). Conclusions Laparoscopic adenomyomectomy can effectively used for uterine adenomyosis.Combined with GnRH-a after adenomyomectomy,the method is more effective in controlling symptoms and reducing disease recurrence.