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目的:探讨术前应用GnRH-a在腹腔镜大子宫肌瘤剔除的可行性及安全性。方法:2005~2009年,对108例大子宫肌瘤(至少1个肌瘤直径≥90 mm)行醋酸亮丙瑞林3.75 mg皮下注射,每月1次,共3次,然后行腹腔镜子宫肌瘤剔除术。结果:用药前肌瘤直径(106±11)mm,1个月后肌瘤直径(98±13)mm,差异无统计学意义(P>0.05),但用药前肌瘤直径和用药2个月后(76±12)mm、用药3个月后(58±12)mm肌瘤直径比较差异有统计学意义(P<0.05)。手术过程顺利,无一例中转开腹。手术时间50~100 min,平均70 min。出血量30~90 ml,平均50 ml。术中无大出血、器官损伤等并发症出现。结论:术前应用GnRH-a在腹腔镜大子宫肌瘤剔除术是安全可行的。
Objective: To investigate the feasibility and safety of preoperative GnRH-a in the removal of laparoscopic large uterine fibroids. Methods: From 2005 to 2009, 108 cases of large uterine fibroids (at least one myoma> 90 mm in diameter) were subcutaneously injected with 3.75 mg of leuprolide once a month for 3 times, and then laparoscopic uterus Myomectomy. Results: The diameter of myoma before treatment was (106 ± 11) mm, and the diameter of fibroids after one month was (98 ± 13) mm. The difference was not statistically significant (P> 0.05) (76 ± 12) mm, and there was significant difference in the diameter of myoma between (58 ± 12) mm after 3 months of treatment (P <0.05). The operation was smooth and no one was transferred to the laparotomy. Surgery time 50 ~ 100 min, an average of 70 min. Bleeding volume 30 ~ 90 ml, an average of 50 ml. Surgery without major bleeding, organ damage and other complications appear. Conclusion: GnRH-a preoperative laparoscopic myomectomy is safe and feasible.