摘要
目的:探究腹腔镜子宫肌瘤剔除术联合左炔诺孕酮宫内缓释系统(LNG-IUS)治疗子宫肌瘤效果。方法:选择2020年11月—2022年11月新泰市人民医院治疗的子宫肌瘤患者74例,应用随机数字表法将其分为对照组(腹腔镜子宫肌瘤剔除术)及观察组(联合左炔诺孕酮宫内缓释系统)各37例,对比两组临床指标[月经失血图(PBAC)评分、子宫内膜厚度、血红蛋白(Hb)]、血清细胞因子[白细胞介素-2(IL-2)、肿瘤坏死因子(TNF-α)、表皮生长因子(EGF)]、相关指标[孕激素受体(PR)、雌激素受体(ER)]、性激素水平[黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E_(2))、孕酮(P)]、并发症发生率。结果:治疗前,两组PBAC评分、子宫内膜厚度、Hb对比差异均无统计学意义(P>0.05);治疗6个月后,两组PBAC评分、子宫内膜厚度均降低,Hb升高,观察组均优于对照组,差异均有统计学意义(P<0.05)。治疗前,两组IL-2、TNF-α、EGF水平对比差异均无统计学意义(P>0.05);治疗6个月后,两组IL-2水平升高,TNF-α、EGF水平均降低,观察组均优于对照组,差异均有统计学意义(P<0.05)。治疗前,两组PR、ER对比差异无统计学意义(P>0.05);治疗6个月后,PR、ER均降低,观察组均低于对照组,差异均有统计学意义(P<0.05)。治疗前,两组LH、FSH、E_(2)、P水平对比差异均无统计学意义(P>0.05);治疗6个月后,两组LH、FSH、E_(2)、P水平均降低,观察组均优于对照组,差异均有统计学意义(P<0.05)。对照组并发症发生率高于观察组,差异有统计学意义(P<0.05)。结论:子宫肌瘤应用腹腔镜下剔除术联合LNG-IUS治疗,效果显著,可调节雌孕激素受体表达,减轻炎症反应,降低LH、FSH、E_(2)、P水平,降低并发症发生率。
Objective:To investigate the effect of laparoscopic myomectomy combined with Levonorgestrelreleasing intrauterine system(LNG-IUS)in the treatment of uterine fibroids.Method:A total of 74 patients with uterine fibroids treated in Xintai People's Hospital were selected from November 2020 to November 2022,and were divided into 37 cases each in the control group(laparoscopic myomectomy)and the observation group(combined with LNG-IUS)by applying the method of random number table,and the clinical indexes[pictorial blood loss assessment chart(PBAC),endometrial thickness,hemoglobin(Hb)],serum cytokines[interleukin-2(IL-2),tumor necrosis factor(TNF-α),epidermal growth factor(EGF)],related indexes[progesterone receptor(PR),estrogen receptor(ER)],sex hormone levels[luteinizing hormone(LH),follicle stimulating hormone(FSH),estradiol(E_(2)),progesterone(P)],and complication rate were compared.Result:Before treatment,the differences between the two groups in comparisons of PBAC,endometrial thickness and Hb were not statistically significant(P>0.05);after 6 months of treatment,the PBAC and endometrial thickness of the two groups were reduced,Hb increased,and those of the observation group were better than those of the control group,the differences were all statistically significant(P<0.05).Before treatment,there were no statistically significant differences in the levels of IL-2,TNF-α and EGF between the two groups(P>0.05);after 6 months of treatment,the levels of IL-2 in the two groups increased,and the levels of TNF-α and EGF decreased,and those in the observation group were better than those in the control group,the differences were all statistically significant(P<0.05).Before treatment,there were no statistical significance in the comparison of PR and ER between the two groups(P>0.05);after 6 months of treatment,PR and ER were reduced,and those in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Before treatment,there were no statistically significant differences in the comparisons of LH,FSH,E_(2) and P levels between the two groups(P>0.05);after 6 months of treatment,LH,FSH,E_(2) and P levels were reduced in both groups,and those in the observation group were better than those in the control group,the differences were all statistically significant(P<0.05).The complication rate of the control group was higher than that of the observation group,the difference was statistically significant(P<0.05).Conclusion:The treatment of uterine fibroids by applying laparoscopic myomectomy combined with LNG-IUS is effective,which can regulate the expression of estrogen and progesterone receptors,reduce the inflammatory response,lower the levels of LH,FSH,E_(2) and P,and reduce the incidence of complications.
作者
张鑫
ZHANG Xin(Xintai People's Hospital,Shandong Province,Xintai 271200,China)
出处
《中国医学创新》
CAS
2023年第25期85-89,共5页
Medical Innovation of China
作者简介
通信作者:张鑫。
