Abstract: Objective To explore the curative effect of laparoscopic removal of giant myoma on the posterior wall of the uterus after pretreatment with leuprolide acetate. Methods A retrospective analysis of 97 patients with giant posterior fibroids received in our hospital from January 2018 to July 2019. Grouped according to the treatment plan, 48 patients who underwent laparoscopic posterior giant fibroids treatment directly as a control group, 49 patients who underwent laparoscopic posterior uterine myomectomy after pretreatment with leuprolide acetate were used as the observation group. The observation group was analyzed for changes in uterine volume and fibroids volume before and after pretreatment. The two groups were related to surgery. Indicators (operation time, intraoperative blood loss, time to get out of bed for the first time, length of hospital stay), the recurrence rate of fibroids in 3 months after operation. Results After pretreatment, the volume of uterus and fibroids in the observation group were smaller than those before pretreatment (P<0.05); the operation time, time to get out of bed for the first time, and hospital stay in the observation group were shorter than those of the control group, and the blood loss during operation was less than that of the control group (P<0.05). Three months after the operation, the recurrence rate of fibroids was 2.04% (1/49) in the observation group and 6.25% (3/48) in the control group, there was no significant difference (P>0.05). Conclusion The pretreatment of leuprolide acetate for injection can significantly reduce the size of uterine fibroids and uterus, help shorten the operation time of laparoscopic posterior wall huge myomectomy, reduce intraoperative damage, and speed up postoperative recovery. Surgery after treatment is an effective treatment for giant uterine fibroids in the posterior wall.

Key words: laparoscopic resection of giant fibroids in the posterior wall of uterus, uterine fibroids, leurelin acetate, pretreatment, recurrence rate

摘要： 目的 探究应用醋酸亮丙瑞林预处理后行腹腔镜子宫后壁巨大肌瘤剥除术的疗效观察。方法 回顾性分析我院2018年1月~2019年7月接收的后壁巨大子宫肌瘤患者97例,根据治疗方案分组,将直接行腹腔镜子宫后壁巨大肌瘤剥除术治疗的48例作为对照组,将醋酸亮丙瑞林预处理后行腹腔镜子宫后壁巨大肌瘤剥除术的49例作为观察组,分析观察组预处理前后子宫体积及肌瘤体积变化、2组手术相关指标（手术时间、术中出血量、首次下床时间、住院时间）、术后3个月肌瘤复发率。结果 预处理后观察组子宫体积、肌瘤体积小于预处理前（P<0.05）;观察组手术时间、首次下床时间、住院时间短于对照组,术中失血量少于对照组（P<0.05）;术后3个月,观察组肌瘤复发率2.04%（1/49）与对照组6.25%（3/48）相比无显著差异（P>0.05）。结论 注射用醋酸亮丙瑞林预处理可显著缩小子宫肌瘤及子宫体积,有助于缩短行腹腔镜子宫后壁巨大肌瘤剥除术手术时间,减轻术中损伤,加快术后康复,预处理后手术是治疗后壁巨大子宫肌瘤有效方案。

关键词: 腹腔镜子宫后壁巨大肌瘤剥除术, 子宫肌瘤, 醋酸亮丙瑞林, 预处理, 复发率