康清华 肖龙华 肖文琴

[摘要] 目的 探讨腹腔镜下病灶切除联合曼月乐治疗子宫腺肌病的临床效果。 方法 回顾性分析2012年2月～2013年4月我院收入行腹腔镜下子宫腺肌病病灶切除的患者66例，根据其采用的治疗方式分为对照组、联合组，对照组（30例）采用单纯病灶切除手术治疗，联合组（36例）在病灶切除的基础上加用曼月乐，比较两组患者术前术后的痛经、月经周期、经期、经量等情况及两组的不良反应发生率。 结果 两组患者术前的痛经视觉模拟评分、月经周期、经期、经量差异无统计学意义（P>0.05）；联合组患者的术后12、24个月的痛经视觉模拟评分及术后24个月的经期、经量与同期对照组差异有统计学意义（P<0.05）。 结论 腹腔镜下子宫腺肌病病灶切除术联合曼月乐治疗子宫腺肌病的临床效果较理想，值得临床优先考虑选用。

[关键词] 腹腔镜；子宫腺肌病；曼月乐；病灶切除

[中图分类号] R711.74 [文献标识码] A [文章编号] 1674-4721（2016）02（b）-0068-03

Clinical effect of laparoscopic lesionectomy combined with Mirena in treatment of adenomyosis

KANG Qing-hua XIAO Long-hua XIAO Wen-qin

Department of Gynaecology and Obstetrics，Wanan Traditional Chinese Medicine Hospital in Jiangxi Province，Wanan 343800，China

[Abstract] Objective To discuss the clinical effect of laparoscopic lesionectomy combined with Mirena in treatment of adenomyosis. Methods 66 patients with adenomyosis receiving laparoscopic lesionectomy in our hospital from February 2012 to April 2013 were retrospectively analyzed and divided into control group and combination group according to the method of treatment.30 patients in control group were treated by simple lesionectomy，while the 36 patients in combination group were treated by lesionectomy plus Mirena.The condition of dysmenorrheal，menstrual cycle，menstrual period，menstrual volume before and after operation in patients between two groups and incidence rate of adverse reaction between two groups was compared respectively. Results There was no statistical difference of visual analogue scale for dysmenorrhea，menstrual cycle，menstrual period，menstrual volume before operation between two groups （P>0.05）.There was a statistical difference of visual analogue scale for dysmenorrhea after 12，24 months and menstrual period，menstrual volume after 24 months in patients of combination group compared with that of control group at the same period （P<0.05）. Conclusion The clinical effect of laparoscopic lesionectomy combined with Mirena is favorable in treatment of adenomyosis，which is worthy to be considered as a preferred method in clinic.

[Key words] Laparoscope；Adenomyosis；Mirena；Lesionectomy

子宫腺肌病是一种常见的妇科疾病，好发于育龄妇女，可出现痛经、经量增多等症状，甚至可导致不孕，给患者的身体及心理健康造成极大的影响[1-3]。为有效治疗子宫腺肌病，同时保留患者的子宫以满足其生育要求，腹腔镜下子宫腺肌病病灶切除术成为许多患者和医务人员的首选治疗方案。本研究着重探讨腹腔镜下子宫腺肌病病灶切除联合曼月乐治疗的临床效果，现报道如下。

1 资料与方法

1.1 一般资料

选取2012年2月～2013年4月我院收入行腹腔镜下子宫腺肌病病灶切除的患者66例，随机分为对照组、联合组。所有患者均通过超声、MRI及血清CA125检查确诊为局限性病变的子宫腺肌病，术前诊刮排除内膜癌及宫内占位性病变可能，且术后病理检查结果证实，所有患者均有痛经，所有患者的术前腺肌瘤病灶直径≤6 cm，同时排除术前子宫体积过大（子宫大小>160 cm3）患者。联合组……