Objective:To evaluate the effect of hysteroscopic electroresection in treating submucosal uterine fibroids.Methods:Using the random number table method,70 patients with submucosal uterine fibroids were divided into tw...Objective:To evaluate the effect of hysteroscopic electroresection in treating submucosal uterine fibroids.Methods:Using the random number table method,70 patients with submucosal uterine fibroids were divided into two groups,35 cases/group.The control group underwent laparoscopic myomectomy,and the observation group underwent hysteroscopic electroresection.Surgical indicators,sex hormone indicators,inflammation indicators,and treatment effects were compared between the two groups.Results:The surgical indicators,sex hormone indicators,and inflammatory indicators three months after operation in the observation group were all more ideal than those of the control group.The total effective rate of the observation group(97.14%)was higher than that of the control group(P<0.05).Conclusion:Hysteroscopic electroresection for the treatment of submucosal uterine fibroids was less invasive,accelerates recovery,and is more effective.展开更多
Introduction: Uterine fibroids are the most common gynecological tumors in women of childbearing age and have multiple clinical manifestations. Objective: To determine factors associated with uterine fibroids in the B...Introduction: Uterine fibroids are the most common gynecological tumors in women of childbearing age and have multiple clinical manifestations. Objective: To determine factors associated with uterine fibroids in the Borgou department of Benin in 2022. Method: Descriptive, analytical cross-sectional study from August 22 to September 22, 2022. The sample consisted of women consulting for gynecological problems in 6 hospitals in the Borgou department in the North of Benin. Results: Of the 744 women surveyed, 10.1% were diagnosed with uterine fibroids. Women with uterine fibroids were often married, paucigesture, and nulliparous. Their main reasons for consultation were the desire for motherhood (50.7%), pelvic pain (46.7%), and genital hemorrhage (14.7%). Age, history of miscarriage, high blood pressure, and diabetes were significantly associated with the presence of uterine fibroids (Conclusion: Uterine fibroids are common in hospitals in northern Benin. There were factors associated with them that should be taken into account in management strategies.展开更多
Objective: To analyze the application value of surgical nursing in patients with uterine fibroids and diabetes. Method: Sixty diabetic patients who agreed to undergo surgery for uterine fibroids at the Sun Yat-sen Uni...Objective: To analyze the application value of surgical nursing in patients with uterine fibroids and diabetes. Method: Sixty diabetic patients who agreed to undergo surgery for uterine fibroids at the Sun Yat-sen University Cancer Center from January 2021 to May 2022 were randomly selected as the study subjects. According to criteria such as number of patients, age, nursing methods, and treatment methods, the patients were evenly divided into an observation group and a control group. The control group received routine nursing measures, while the observation group received focused surgical nursing measures based on the routine ones. The blood glucose and blood lipid metabolism status, the incidence of adverse reactions, and nursing satisfaction were compared between the two groups. Results: The blood glucose and blood lipid metabolism status of the observation group were safer than those of the control group (P < 0.05). The observation group had advantages in terms of the incidence of adverse reactions and nursing satisfaction compared to the control group (P Conclusion: Systematic surgical nursing for patients with uterine fibroids and diabetes during surgery can help patients control their blood glucose and blood lipid metabolism status, reduce the incidence of adverse reactions, and improve the patient’s experience during the treatment stage.展开更多
Background: Uterine fibroids are a common condition in Senegal and often symptomatic. Our study aims to determine the epidemiological profile, to clarify the diagnostic aspects and to evaluate the surgical management ...Background: Uterine fibroids are a common condition in Senegal and often symptomatic. Our study aims to determine the epidemiological profile, to clarify the diagnostic aspects and to evaluate the surgical management of patients with uterine fibroids. Patients and Method: We carried out a retrospective and descriptive study carried out over a period of 30 months, from August 1, 2017 to January 31, 2020, concerning all patients who underwent surgery for the treatment of uterine myomatosis in the department of Gynecology Obstetrics of the Hospital Principal of Dakar. The data was collected from the patients’ medical records and analyzed using Excel version 2016 and R version 4 software. Results: We collected 175 surgical interventions for uterine fibroids, representing 44.7% of gynecological interventions. Most of the patients were between 30 and 39 years old, with an average age of 39 years. The nulliparous were the majority with 64.6%. The clinical symptomatology was represented by genital bleeding (32.6%), pelvic pain (18.85%) and infertility (12.6%). The diagnosis was confirmed by pelvic ultrasound in all patients with variable myoma topography. A myomectomy was performed in 82.3% of cases and a total hysterectomy in 17.7%. The postoperative course was simple in 94.2% of cases, and the results of treatment revealed a disappearance of symptoms in 94.3% of cases. Conclusion: Surgery occupies a prominent place in the management of uterine fibroids.展开更多
Background: Uterine fibroid is the most common benign gynecological tumor in women of childbearing age and is common in our context. It can be discovered incidentally or by metrorrhagia. Objective: To study the epidem...Background: Uterine fibroid is the most common benign gynecological tumor in women of childbearing age and is common in our context. It can be discovered incidentally or by metrorrhagia. Objective: To study the epidemiological, clinical, therapeutic and prognostic aspects of uterine fibroids operated in the gynaecology and obstetrics department of the CHU-T. Patients and Method: This was a descriptive cross-sectional study including all patients operated on for uterine fibromyoma in the gynaecology-obstetrics department. The collection mode was retrospective, over a 5-year period from January 1, 2017 to December 31, 2021 in the mother-child department of the CHU-T. Data entry and analysis were carried out on a microcomputer using Epi info 7.2.5 software. Results: We collected 109 cases of uterine fibroids which represented 42.5% of the surgical activities of the gynaecology department. The average age of the patients was 38.9 years ± 7.8. Married women represented 77.1%. Salaried women accounted for 65.1%. The main reasons for consultation were uterine haemorrhage (53.1%), pelvic pain (40.4%) and hypofertility (31.2%). Ultrasound was performed in all patients to help map the fibroid nuclei. The main indication for surgery was haemorrhagic myoma (43.1%). The surgical treatment was conservative (myomectomy) in 58.7% of cases and radical (hysterectomy) in 27.4% of cases. The most frequent postoperative complication was vulvar haemorrhage and the average hospital stay was 4 days ± 1.4. Anatomical pathological examination of the surgical excision specimen carried out on 30 operated patients concluded that uterine leiomyoma was diagnosed in 100% of cases. Conclusion: Patient education for early detection, universal health insurance and cost subsidies could improve the management of this condition.展开更多
BACKGROUND High-intensity focused ultrasound(HIFU) ablation is a minimally invasive approach in gynecology that is used to manage uterine fibroids.Although this procedure is safe and effective,adverse outcomes are bec...BACKGROUND High-intensity focused ultrasound(HIFU) ablation is a minimally invasive approach in gynecology that is used to manage uterine fibroids.Although this procedure is safe and effective,adverse outcomes are becoming a major problem.CASE SUMMARY We present a case of ventral hernia that occurred as a rare and delayed complication of HIFU ablation for uterine fibroids treatment.The patient came to the hospital with abdominal bloating that occurred 6 mo after ultrasound-guided HIFU ablation for managing uterine fibroids.The ventral hernia,which occurred due to atrophied muscle layers following the procedure,was confirmed by imaging studies and intraoperative findings.She required a hernia repair with mesh and hysterectomy for definitive treatment of uterine fibroid.CONCLUSION High-intensity ultrasound ablation should be performed only on appropriate candidates.Patients should be educated about potential complications of the procedure and the possibility of subsequent treatment.Post-procedural long-term follow-up for detecting delayed adverse effects is important.展开更多
Uterine fibroids are the most common benign tumors in gynecology.Traditional Chinese medicine treats uterine fibroids according to syndrome differentiation and treatment.The treatment of uterine fibroids has the chara...Uterine fibroids are the most common benign tumors in gynecology.Traditional Chinese medicine treats uterine fibroids according to syndrome differentiation and treatment.The treatment of uterine fibroids has the characteristics of definitive curative effects and minor side-effects,but there are also many shortcomings,which require more in-depth research and exploration.展开更多
Objective:To compare the clinical efficacy of Gongliuqing Capsule(宫瘤清胶囊)combined with mifepristone,Guizhi Fuling Capsule(桂枝茯苓胶囊)combined with mifepristone,and single mifepristone in the treatment of uterine...Objective:To compare the clinical efficacy of Gongliuqing Capsule(宫瘤清胶囊)combined with mifepristone,Guizhi Fuling Capsule(桂枝茯苓胶囊)combined with mifepristone,and single mifepristone in the treatment of uterine fibroids.Methods:Retrospective analysis was performed on 307 patients with uterine fibroids receiving drug treatment in our hospital.All 307 patients has been divided into three groups according to the different drug delivery scheme,GLM group of 125 patients taking Gongliuqing Capsule and mifepristone,GFM group of 113 patients taking Guizhi Fuling Capsule(桂枝茯苓胶囊)and mifepristone,SM group of 69 patients only taking mifepristone.Comparison of the cure rate and effective rate,volume of menstruation,menstrual period and uterine fibroids,level of estrogen and the incidence of adverse reaction of the patients of the 3 groups.Results:After 90days of treatment,the efficiency of GLM and GFM group were higher than that of SM group(P<0.05),and there was no significant difference between GLM and GFM group(P>0.05).The cure rate of GLM group was higher than that of the other two groups,and the difference was statistically significant(P<0.05).The menstrual volume and period length,uterine fibroids volume of GLM and GFM group was smaller than that of SM group(P<0.05),and there was no significant difference between GLM and GFM group(P<0.05).The P and E2 level of GLM and GFM group was lower than that of SM group(P<0.05),and there was no significant difference between GLM and GFM group(P>0.05).There was no significant difference in the incidence of other sex hormone level and adverse reactions(P>0.05).Conclusions:Compared with the SM to treat uterine fibroids,the integrative medicine therapy were better.Among them,Gongliuqing Capsule(宫瘤清胶囊)combined with mifepristone has the highest cure rate.展开更多
Uterine fibroids are common in females of reproductive age and substantially affecting fertility and quality of life. Current management strategies mainly involve surgical interventions. For treatment, options availab...Uterine fibroids are common in females of reproductive age and substantially affecting fertility and quality of life. Current management strategies mainly involve surgical interventions. For treatment, options available are surgical and non-surgical, but the mode of management leans on several factors, such as severity of symptoms, patient’s age, myoma characteristics, desire to preserve uterus and fertility. Alternative approach to surgery for the treatment of symptomatic females with uterine myomas has been recognized. Ulipristal acetate (UPA) has been the first selective progesterone-receptor modulator (SPRM) approved for the pre-operative and long-term management of uterine fibroids. There are evidences promoting an important role for progesterone pathways in the pathophysiology of uterine fibroids which supports the use of ulipristal acetate. The availability of alternative choices to surgical intervention is very necessary especially for those willing to preserve uterus and fertility. One of the alternatives is with ulipristal acetate, which has been proven to treat fibroid symptoms effectively.展开更多
Background:Single or multiple thyroid nodules and uterine fibroids are the most common benign gynecologic disease.An increasing number of breast cancer are accompanied with thyroid nodules or uterine fibroids or both ...Background:Single or multiple thyroid nodules and uterine fibroids are the most common benign gynecologic disease.An increasing number of breast cancer are accompanied with thyroid nodules or uterine fibroids or both of them.However,the incidence of thyroid nodules or uterine fibroids in patients with different subtypes of breast cancer is unclear.Objective:To study the incidence of thyroid nodules or uterine fibroids in patients with different subtypes of breast cancer.Methods:A retrospective cohort study conducted in the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine(China)that included 1,322 female cancer survivors who went to our hospital from January 2014 to November 2019.In this study,we evaluated the frequency of thyroid nodules and uterine fibroids in breast cancer survivors in comparison with other cancer survivors.Besides,we compare the frequency of thyroid nodules and uterine fibroids among different luminal breast cancer.Results:In this study,there were 245 breast cancer survivors,including 58 cases with thyroid nodule,52 cases with uterine fibroids,17 cases with both,152 cases with none.And 1,077 other cancer survivors were collected,including 142 cases with thyroid nodule,172 cases with uterine fibroids,25 cases with both,788 cases with none.According to statistical analysis,the incidence of thyroid nodule and uterine fibroids in breast cancer patients is significantly higher than that in non-breast cancer patients(P<0.01 and P<0.05).Between the molecular classification of breast cancer,among 245 BC patients,58 were combined with thyroid nodule,including 57 cases of luminal-A type BC and 22 cases of combined thyroid nodule;101 cases of luminal-B type BC and 20 cases of combined thyroid nodule;50 cases of HER2-positive over expression type BC and 13 cases of combined thyroid nodule;37 cases of TNBC and 3 cases of combined thyroid nodule,Patients with luminal-A BC have a higher incidence of thyroid nodules compared to other types of BC.Among 245 BC patients,there were 52 cases with uterine fibroids,including 57 cases of luminal-A type BC,5 cases with uterine fibroids;101 cases of luminal-B type BC,32 cases with uterine fibroids;50 cases of HER2-positive over expression type BC,11 cases with uterine fibroids;37 cases of TNBC,4 cases with uterine fibroids.Luminal-B breast cancer is more likely to suffer from uterine fibroids than other types of breast cancer.In addition,breast cancer patients with both thyroid nodules and uterine fibroids had significantly higher luminal-B than other subtypes.Conclusions:This study demonstrates that breast cancer women have a significantly greater incidence rate of thyroid nodules and uterine fibroids,and is higher at Luminal A or Luminal B.We consider these findings may contribute to the identification of liver channel of foot jueyin following underlying this disease association.展开更多
Uterine fibroids are the most common benign tumors in gynecology.Traditional Chinese medicine treats uterine fibroids according to syndrome differentiation and treatment.The treatment of uterine fibroids has the chara...Uterine fibroids are the most common benign tumors in gynecology.Traditional Chinese medicine treats uterine fibroids according to syndrome differentiation and treatment.The treatment of uterine fibroids has the characteristics of definitive curative effects and minor side-effects,but there are also many shortcomings,which require more in-depth research and exploration.展开更多
Purpose: The aim of this study was to systematically review the safety and efficacy of uterine artery embolization(UAE) versus surgery for symptomatic uterine fibroids. Materials and Methods: An electronic search of t...Purpose: The aim of this study was to systematically review the safety and efficacy of uterine artery embolization(UAE) versus surgery for symptomatic uterine fibroids. Materials and Methods: An electronic search of the Cochrane Library, PubMed, Embase and Web of Science databases was conducted from their inception to May 2017 for randomized controlled trials(RCTs) that assessed UAE versus surgery for the treatment of symptomatic uterine fibroids. The references of the included studies were also retrieved. Two reviewers independently screened the studies based on the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality. The meta-analysis was conducted using RevMan 5.3 software. Results: A total of seven RCTs involving 859 patients were included. The results of the meta-analysis showed a shorter hospital stay and recovery time for UAE as compared to surgery. Surgery was not reported to be better for improving health-related quality of life in any of the included studies. There were no significant differences in patient satisfaction(1-2 and 5 years), and intra-procedural complications or major complications(1 year). However, the rates of minor complications(1 year) and further interventions(2 and 5 years) were significantly higher in patients who underwent UAE rather than surgery. The rates of pregnancy and live births were significantly lower among patients who underwent UAE than surgery. Conclusion: UAE is safe and effective, and has the advantages of shorter hospital stay and recovery time as compared to surgery. However, UAE has the risk of re-intervention, and lower pregnancy and live birth rates.展开更多
Purpose: To assess the safety, efficacy and effectiveness of percutaneous radiofrequency (RF) thermal ablation to reduce symptoms of uterine fibroids. Materials and Methods: 17 premenopausal women with symptomatic ute...Purpose: To assess the safety, efficacy and effectiveness of percutaneous radiofrequency (RF) thermal ablation to reduce symptoms of uterine fibroids. Materials and Methods: 17 premenopausal women with symptomatic uterine fibroids despite conventional medical treatment were included. The assessment of symptoms and characteristics of fibroids by vaginal ultrasound, magnetic resonance imaging (MRI) and contrast enhanced ultrasound (CEUS) was performed before starting treatment and 6 months after the procedure. Successful treatment was clinically considered if patients reported a reduction in symptoms 6 months after RF myolysis. Successful treatment was also considered if the necrosis of the fibroid was greater than 50%, 6 months after treatment. Results: The baseline score on visual analogue scale (VAS) for dysmenorrhea and intermenstrual pain was 5.76 ± 3.31 and 3.0 ± 3.4, respectively. According to a score of 0 - 3, baseline bleeding during menstruation was 2.29 ± 0.92. Six months after RF myolysis, the VAS for dysmenorrhea was 2.75 ± 3.32 (p = 0.004), whereas for intermenstrual pain it was 1.38 ± 2.56 (p = 0.02). Menstrual bleeding was reduced to 1.13 ± 0.89 (p = 0.005). Clinical success of the treatment was evident in 11 (64.7%) of the 17 patients with a 95% CI [38.6%, 84.7%]. Fourteen patients underwent MRI monitoring 6 months post-myolysis. Compared to baseline fibroid volume, ultrasound and MRI volume were 57.38% and 79.66% six months after surgery, respectively. A total of 13 patients (92.86%) had radiological success from the treatment (95% CI [64.2%, 99.6%]). Conclusion: Since percutaneous RF myolysis reduces volume and symptoms of uterine fibroids, it may be considered as a valid treatment for symptomatic fibroids.展开更多
Objective: To evaluate the outcomes of selective uterine artery embolization (SUAE) in treatment of symptomatic uterine fibroids using Color Doppler ultrasonography (CDUS). Methods: As the procedure SUAE for fibroids,...Objective: To evaluate the outcomes of selective uterine artery embolization (SUAE) in treatment of symptomatic uterine fibroids using Color Doppler ultrasonography (CDUS). Methods: As the procedure SUAE for fibroids, prospective data of the initial 65 consecutive women treated from March 2007 to September 2009 were collected. The follow-up period from 1 week to 30 months, using questionnaires, we investigated the fibroid-related physical and psychological symptoms, and the cumulative rates of symptom control, gynecologic interventions, and complications. The volumes of uterine and uterine fibroids were calculated by CDUS pre- and post-SUAE for 6 months. And we tested the levels of internal hormone including FSH, LH and E2 before and after SUAE for 3, 6 months. Results: SUAE was performed successfully in all patients. There was no peri-operative morbidity in all procedures. Compared with pre-SUAE volumes of uterine [(322±112) cm3] and uterine fibroids [(125±46) cm3], their volumes in post-SUAE were (144±72) cm3 and (51±11) cm3 (P<0.01), and reduction rate was 58% and 61%, respectively. At 3, 6 months after SUAE, levels of FSH, LH, and E2 were not decreased than that of in pre-SUAE (P>0.05). After SUAE for 24 months, the fibroids related physical and psychological symptoms such as bleeding, pain and quality of life were significantly improved (P<0.01). 90.8% (59/65) women had resolution of symptoms and no significant post-procedural symptoms. Parts of patients discharge necrotic fibroids. 86% (34/40) complications were minor, requiring no therapy. 9.2% (6/65) had significant post-procedural symptoms, requiring therapy in hospital or out-patient department. Conclusion: SUAE contributes to a long-term significant improvement of all investigated uterine fibroid-related symptoms and markedly improves women's health-related quality of life. SUAE that no impair on changes of internal hormone, under suitable conditions, represents an attractive alternative to hysterectomy for the treatment of symptomatic fibroids and is a minimally invasive, new method of good clinical prognosis. CDUS is an effective to investigate the outcome of SUAE.展开更多
Objective The aim of this study was to investigate the energy deposition in the target area of high intensity focused ultrasound(HIFU) with ultrasound-guided intra-hysteromyoma injection of ethyl alcohol absolute Meth...Objective The aim of this study was to investigate the energy deposition in the target area of high intensity focused ultrasound(HIFU) with ultrasound-guided intra-hysteromyoma injection of ethyl alcohol absolute Methods Eighty patients with hysteromyomas were randomly divided into two groups: group HIFU(group H) and group HIFU combined with ultrasound-guided intra-hysteromyoma injectionn of ethyl alcohol absolute(group E + H). Patients in group E + H received an ultrasound-guided injection of absolute ethyl alcohol 1 h before HIFU treatment. The irradiation time, irradiation dose, energy efficiency factor(radiation energy required for ablation of a myoma per unit of volume), grey variation, pain score, and adverse reactions were compared between the two groups. An independent sample t-test was used with a twotailed P-value of < 0.05.Results The irradiation time, irradiation dose, and energy efficiency factor were significantly lower in group E + H than those in group H(P < 0.05). The hysteromyomas of patients in group E+H appeared as dominantly hyperechoic masses, and those of patients in group H appeared as hyperechoic tissue(nonmass). The incidence of adverse reactions and pain score were higher in group H than those in group E + H(P < 0.05).Conclusion Ultrasound-guided intra-hysteromyoma injection of ethyl alcohol absolute can enhance the energy deposition of HIFU in the uterine fibroids, improve the treatment efficiency, shorten the treatment time, reduce the treatment dose, and reduce the pain and complications for the patients.展开更多
Introduction: Uterine leiomyomas, commonly called fibroids are benign tumors of uterine myometrium composing of smooth muscle with variable amount of connective tissue and common gynecological problem among women of r...Introduction: Uterine leiomyomas, commonly called fibroids are benign tumors of uterine myometrium composing of smooth muscle with variable amount of connective tissue and common gynecological problem among women of reproductive age. It is the commonest tumor of the female pelvic organ. Objective: To determine the incidence of uterine fibroids, socio-demographic, clinical characteristics and outcome of uterine leiomyoma management. Material and Methods: This is a retrospective descriptive analysis of all the uterine fibroids carried out at the University of Abuja Teaching Hospital, Gwagwalada from 4th January 2013 to 31st December 2017. Data were obtained from medical records, gynaecological ward and theatre records of University of Abuja Teaching Hospital. Data were analyzed using socio-demographic, clinical characteristics and outcome of uterine leiomyoma management. Results were presented using simple percentages and ratios. Results: Uterine fibroids accounted for 6.4% of all gynaecological admissions and 21. 3% of all major gynaecological surgeries. Uterine fibroid was found to be common between the age range 30 - 39 (47.5%) years, followed by 20 - 29 (26.3%) and 40 - 49 (15.7%) years. One hundred and twenty-two (61.7%) were nulliparous while 48 (24.2%) were primiparous. Majority of the women 88 (44.4%) had tertiary education, 49 (24.7%) secondary, 48 (24.3%) primary and 13 (6.6%) had no formal education. Seventy-six (38.4%) presented with menorrhagia, abdominal mass 71 (35.9%), infertility 68 (34.3%) and abdominal pain 48 (24.2%). Most of the patients had multiple fibroids, 81 (40.9%) had intramural, 70 (35.4%) submucous and 52 (26.3%) subserous. Out of 198, 165 (83.3%) had myomectomy, 23 (11.6%) had total abdominal hysterectomy and 9 (4.6%) myomectomy and tuboplasty. Anaemia 41 (20.7%) was the commonest morbidity, followed by wound infection 12 (6.1%) and wound dehiscence 4 (2.0%). No mortality was recorded during the period under review. Conclusion: Uterine fibroid is common in our environment and usually presents with menorrhagia, abdominal mass, infertility, pelvic pain, and recurrent miscarriage. Thus healthy lifestyle should be encouraged and routine checkups conducted so as to detect and possibly treat such tumours early.展开更多
The objective of this study was to investigate the clinical efficacy of carboprost tromethamine combined with mifepristone in the treatment of uterine fibroids.A total of 66 patients with uterine fibroids admitted to ...The objective of this study was to investigate the clinical efficacy of carboprost tromethamine combined with mifepristone in the treatment of uterine fibroids.A total of 66 patients with uterine fibroids admitted to our hospital between April 2018 and January 2019 were selected as subjects.According to the two different treatment methods,patients were divided equally:The observation group and the control group,each group of 33 people.The oxytocin drug treatment was medicated to the control group,and the prostaglandin tromethamine combined with mifepristone was medicated to the observation group.The treatment effect,adverse reaction,operation,and uterine muscle before and after surgery were observed in these two groups:Tumor tissue progesterone receptor and estrogen receptor levels.The clinical treatment effect of the observation group was 93.94%,and the clinical treatment effect of the control group was 60.61%.The clinical treatment effect of the observation group was significantly higher than that of the control group;furthermore,the incidence of adverse reactions in the observation group in terms of rash,fatigue,nausea,and vomiting was much lower than the control group and could observe a significant difference.Finally,in observation group,the amount of intraoperative blood loss,operation time,and hospitalization time was better than those of the control group.The progesterone receptor and estrogen receptor levels in the uterine fibroid tissue after surgery should also be better than the control group,and it is worth to make a further comparison.Carboprost tromethamine combined with mifepristone is effective in the treatment of uterine fibroids and can be further developed.展开更多
Objective:To investigate the effect of Guizhi Fuling Capsule on sex hormones and tumor markers in patients with uterine fibroids, and observe its clinical efficacy.Methods: A total of 120 patients with uterine fibroid...Objective:To investigate the effect of Guizhi Fuling Capsule on sex hormones and tumor markers in patients with uterine fibroids, and observe its clinical efficacy.Methods: A total of 120 patients with uterine fibroids who were treated in our hospital from August 2016 to August 2017 were selected according to the order of treatment and divided into observation group and control group, 60 cases each. Mifepristone was administered to the control group and mifepristone combined with Guizhi Fuling Capsules was administered to the observation group. The levels of hemoglobin, vascular endothelial growth factor (VEGF), sex hormones, tumor markers, and inflammatory factors before and after treatment were compared between the two groups.Result:The levels of hemoglobin, vascular endothelial growth factor (VEGF), sex hormones, tumor markers, and inflammatory factors before and after treatment were compared between the two groups. After treatment, hemoglobin levels increased significantly in the two groups, VEGF, sex hormones FSH, LH and E2, tumor markers HE4, CA125, inflammatory cytokines TNF-α and IFN-γ levels decreased significantly. The hemoglobin level of the observation group was (117.09±11.51) g/L higher than that of the control group , and the level of VEGF was (0.69±0.06) pg/mL lower than that of the control group. The levels of sex hormone FSH, LH and E2 in the observation group were (15.87±1.56) U/L, (10.69±1.06) U/L and (4.95±0.51) pmol/L lower than those of the control group. The levels of HE4, CA125, TNF-α and IFN-γ gamma in the observation group were (52.47±5.24) pmol/L, (15.46±1.53) U/mL, (40.41±4.05) and (16.72±1.62) pg/mL lower than those of the control group.Conclusion:Guizhi Fuling Capsule can significantly improve the level of sex hormones and tumor markers, relieve inflammatory stress and improve the therapeutic effect.展开更多
Objective: To study the effect of dexmedetomidine in high intensity focused ultrasound treatment of uterine fibroids on pain degree, pain mediator and stress mediator secretion as well as stress signal molecule expres...Objective: To study the effect of dexmedetomidine in high intensity focused ultrasound treatment of uterine fibroids on pain degree, pain mediator and stress mediator secretion as well as stress signal molecule expression. Methods: 78 patients with uterine fibroids who received high intensity focused ultrasound treatment in Shaanxi Second Provincial People's Hospital between February 2015 and February 2018 were selected as the research subjects and randomly divided into the Dex group who accepted dexmedetomidine + fentanyl + midazolam anesthesia and the control group who accepted fentanyl + midazolam anesthesia. The pain degree was assessed 1 day and 3 d after surgery;the secretion of pain mediators and stress mediators in serum as well as the expression levels of stress signaling molecules in peripheral blood were measured before surgery and 3 d after surgery. Results: 1 d and 3 d after surgery, the NRS pain scores of Dex group were significantly lower than those of control group;3 d after surgery, serum SP, BK, 5-HT, IL-6, IL-8, NE, COR, ACTH and MDA contents as well as peripheral blood NF-κB, p38MAPK, NOX4 and Nrf2 expression of both groups of patients were higher than those before surgery whereas serum SOD and HO-1 contents as well as peripheral blood Keap1 expression were lower than those before surgery, and serum SP, BK, 5-HT, IL-6, IL-8, NE, COR, ACTH and MDA contents as well as peripheral blood NF-κB, p38MAPK, NOX4 and Nrf2 expression of Dex group 3 d after surgery were lower than those of control group whereas serum SOD and HO-1 contents as well as peripheral blood Keap1 expression were higher than those of control group. Conclusion: The application of dexmedetomidine in high intensity focused ultrasound treatment of uterine fibroids can reduce the degree of postoperative pain and stress response.展开更多
Objective:To investigate the effects of Gongliuxiao Capsule on inflammatory factors, tumor markers, sex hormones and vascular endothelial function in patients with uterine fibroids. Methods:130 patients with uterine f...Objective:To investigate the effects of Gongliuxiao Capsule on inflammatory factors, tumor markers, sex hormones and vascular endothelial function in patients with uterine fibroids. Methods:130 patients with uterine fibroids admitted to our hospital from October 2015 to March 2017 were enrolled. According to the treatment, they were divided into single treatment group and combined medication group, with 65 cases in each group. The changes of inflammatory factors, tumor markers, sex hormones and vascular endothelial function were compared before and after treatment in the two groups.Results: There were no significant differences in the levels of sex hormones, inflammatory factors, tumor markers and vascular endothelial function between the two groups (P>0.05). The levels of sex hormones E2, P, FSH and LH, the levels of inflammatory factors TNF-α, MMP-9 and IGF-1, tumor markers CA125, CA19-9 and vascular endothelial function VEGF and b-FGF were significantly lower in the two groups (P<0.05). The levels of E2, P, FSH and LH in the combined drug groupswere (154.12±16.20) pmol/L, (9.12±1.02) μg/L, (13.84±1.42) U/L and (12.77±1.36) U/L, respectively,which were significantly lower than the single drug group level (P<0.05). The levels of CA125 and CA19-9 in the combined drug group were (27.89±2.88) U/mL and (28.09±3.04) U/mL, respectively, which were significantly lower than the single drug group (P<0.05). The levels of TNF-α, MMP-9 and IGF-1 in the combined drug group were (24.16±2.63) ng/L, (159.22±16.82) μg/L and (69.75±7.09) μg/L, respectively, which were significantly lower than the single drug group(P<0.05). The levels of VEGF and b-FGF in the combination group were (138.29±14.32) μg/L and (98.59±10.02) μg/L, respectively, which were significantly lower than the single drug group (P<0.05).Conclusion:Mifepristone combined with Gongliuxiao Capsule can alleviate endocrine disorders, relieve inflammatory stress response and improve vascular endothelial function in patients with uterine fibroids. It is worthy of clinical application.展开更多
文摘Objective:To evaluate the effect of hysteroscopic electroresection in treating submucosal uterine fibroids.Methods:Using the random number table method,70 patients with submucosal uterine fibroids were divided into two groups,35 cases/group.The control group underwent laparoscopic myomectomy,and the observation group underwent hysteroscopic electroresection.Surgical indicators,sex hormone indicators,inflammation indicators,and treatment effects were compared between the two groups.Results:The surgical indicators,sex hormone indicators,and inflammatory indicators three months after operation in the observation group were all more ideal than those of the control group.The total effective rate of the observation group(97.14%)was higher than that of the control group(P<0.05).Conclusion:Hysteroscopic electroresection for the treatment of submucosal uterine fibroids was less invasive,accelerates recovery,and is more effective.
文摘Introduction: Uterine fibroids are the most common gynecological tumors in women of childbearing age and have multiple clinical manifestations. Objective: To determine factors associated with uterine fibroids in the Borgou department of Benin in 2022. Method: Descriptive, analytical cross-sectional study from August 22 to September 22, 2022. The sample consisted of women consulting for gynecological problems in 6 hospitals in the Borgou department in the North of Benin. Results: Of the 744 women surveyed, 10.1% were diagnosed with uterine fibroids. Women with uterine fibroids were often married, paucigesture, and nulliparous. Their main reasons for consultation were the desire for motherhood (50.7%), pelvic pain (46.7%), and genital hemorrhage (14.7%). Age, history of miscarriage, high blood pressure, and diabetes were significantly associated with the presence of uterine fibroids (Conclusion: Uterine fibroids are common in hospitals in northern Benin. There were factors associated with them that should be taken into account in management strategies.
文摘Objective: To analyze the application value of surgical nursing in patients with uterine fibroids and diabetes. Method: Sixty diabetic patients who agreed to undergo surgery for uterine fibroids at the Sun Yat-sen University Cancer Center from January 2021 to May 2022 were randomly selected as the study subjects. According to criteria such as number of patients, age, nursing methods, and treatment methods, the patients were evenly divided into an observation group and a control group. The control group received routine nursing measures, while the observation group received focused surgical nursing measures based on the routine ones. The blood glucose and blood lipid metabolism status, the incidence of adverse reactions, and nursing satisfaction were compared between the two groups. Results: The blood glucose and blood lipid metabolism status of the observation group were safer than those of the control group (P < 0.05). The observation group had advantages in terms of the incidence of adverse reactions and nursing satisfaction compared to the control group (P Conclusion: Systematic surgical nursing for patients with uterine fibroids and diabetes during surgery can help patients control their blood glucose and blood lipid metabolism status, reduce the incidence of adverse reactions, and improve the patient’s experience during the treatment stage.
文摘Background: Uterine fibroids are a common condition in Senegal and often symptomatic. Our study aims to determine the epidemiological profile, to clarify the diagnostic aspects and to evaluate the surgical management of patients with uterine fibroids. Patients and Method: We carried out a retrospective and descriptive study carried out over a period of 30 months, from August 1, 2017 to January 31, 2020, concerning all patients who underwent surgery for the treatment of uterine myomatosis in the department of Gynecology Obstetrics of the Hospital Principal of Dakar. The data was collected from the patients’ medical records and analyzed using Excel version 2016 and R version 4 software. Results: We collected 175 surgical interventions for uterine fibroids, representing 44.7% of gynecological interventions. Most of the patients were between 30 and 39 years old, with an average age of 39 years. The nulliparous were the majority with 64.6%. The clinical symptomatology was represented by genital bleeding (32.6%), pelvic pain (18.85%) and infertility (12.6%). The diagnosis was confirmed by pelvic ultrasound in all patients with variable myoma topography. A myomectomy was performed in 82.3% of cases and a total hysterectomy in 17.7%. The postoperative course was simple in 94.2% of cases, and the results of treatment revealed a disappearance of symptoms in 94.3% of cases. Conclusion: Surgery occupies a prominent place in the management of uterine fibroids.
文摘Background: Uterine fibroid is the most common benign gynecological tumor in women of childbearing age and is common in our context. It can be discovered incidentally or by metrorrhagia. Objective: To study the epidemiological, clinical, therapeutic and prognostic aspects of uterine fibroids operated in the gynaecology and obstetrics department of the CHU-T. Patients and Method: This was a descriptive cross-sectional study including all patients operated on for uterine fibromyoma in the gynaecology-obstetrics department. The collection mode was retrospective, over a 5-year period from January 1, 2017 to December 31, 2021 in the mother-child department of the CHU-T. Data entry and analysis were carried out on a microcomputer using Epi info 7.2.5 software. Results: We collected 109 cases of uterine fibroids which represented 42.5% of the surgical activities of the gynaecology department. The average age of the patients was 38.9 years ± 7.8. Married women represented 77.1%. Salaried women accounted for 65.1%. The main reasons for consultation were uterine haemorrhage (53.1%), pelvic pain (40.4%) and hypofertility (31.2%). Ultrasound was performed in all patients to help map the fibroid nuclei. The main indication for surgery was haemorrhagic myoma (43.1%). The surgical treatment was conservative (myomectomy) in 58.7% of cases and radical (hysterectomy) in 27.4% of cases. The most frequent postoperative complication was vulvar haemorrhage and the average hospital stay was 4 days ± 1.4. Anatomical pathological examination of the surgical excision specimen carried out on 30 operated patients concluded that uterine leiomyoma was diagnosed in 100% of cases. Conclusion: Patient education for early detection, universal health insurance and cost subsidies could improve the management of this condition.
文摘BACKGROUND High-intensity focused ultrasound(HIFU) ablation is a minimally invasive approach in gynecology that is used to manage uterine fibroids.Although this procedure is safe and effective,adverse outcomes are becoming a major problem.CASE SUMMARY We present a case of ventral hernia that occurred as a rare and delayed complication of HIFU ablation for uterine fibroids treatment.The patient came to the hospital with abdominal bloating that occurred 6 mo after ultrasound-guided HIFU ablation for managing uterine fibroids.The ventral hernia,which occurred due to atrophied muscle layers following the procedure,was confirmed by imaging studies and intraoperative findings.She required a hernia repair with mesh and hysterectomy for definitive treatment of uterine fibroid.CONCLUSION High-intensity ultrasound ablation should be performed only on appropriate candidates.Patients should be educated about potential complications of the procedure and the possibility of subsequent treatment.Post-procedural long-term follow-up for detecting delayed adverse effects is important.
文摘Uterine fibroids are the most common benign tumors in gynecology.Traditional Chinese medicine treats uterine fibroids according to syndrome differentiation and treatment.The treatment of uterine fibroids has the characteristics of definitive curative effects and minor side-effects,but there are also many shortcomings,which require more in-depth research and exploration.
文摘Objective:To compare the clinical efficacy of Gongliuqing Capsule(宫瘤清胶囊)combined with mifepristone,Guizhi Fuling Capsule(桂枝茯苓胶囊)combined with mifepristone,and single mifepristone in the treatment of uterine fibroids.Methods:Retrospective analysis was performed on 307 patients with uterine fibroids receiving drug treatment in our hospital.All 307 patients has been divided into three groups according to the different drug delivery scheme,GLM group of 125 patients taking Gongliuqing Capsule and mifepristone,GFM group of 113 patients taking Guizhi Fuling Capsule(桂枝茯苓胶囊)and mifepristone,SM group of 69 patients only taking mifepristone.Comparison of the cure rate and effective rate,volume of menstruation,menstrual period and uterine fibroids,level of estrogen and the incidence of adverse reaction of the patients of the 3 groups.Results:After 90days of treatment,the efficiency of GLM and GFM group were higher than that of SM group(P<0.05),and there was no significant difference between GLM and GFM group(P>0.05).The cure rate of GLM group was higher than that of the other two groups,and the difference was statistically significant(P<0.05).The menstrual volume and period length,uterine fibroids volume of GLM and GFM group was smaller than that of SM group(P<0.05),and there was no significant difference between GLM and GFM group(P<0.05).The P and E2 level of GLM and GFM group was lower than that of SM group(P<0.05),and there was no significant difference between GLM and GFM group(P>0.05).There was no significant difference in the incidence of other sex hormone level and adverse reactions(P>0.05).Conclusions:Compared with the SM to treat uterine fibroids,the integrative medicine therapy were better.Among them,Gongliuqing Capsule(宫瘤清胶囊)combined with mifepristone has the highest cure rate.
文摘Uterine fibroids are common in females of reproductive age and substantially affecting fertility and quality of life. Current management strategies mainly involve surgical interventions. For treatment, options available are surgical and non-surgical, but the mode of management leans on several factors, such as severity of symptoms, patient’s age, myoma characteristics, desire to preserve uterus and fertility. Alternative approach to surgery for the treatment of symptomatic females with uterine myomas has been recognized. Ulipristal acetate (UPA) has been the first selective progesterone-receptor modulator (SPRM) approved for the pre-operative and long-term management of uterine fibroids. There are evidences promoting an important role for progesterone pathways in the pathophysiology of uterine fibroids which supports the use of ulipristal acetate. The availability of alternative choices to surgical intervention is very necessary especially for those willing to preserve uterus and fertility. One of the alternatives is with ulipristal acetate, which has been proven to treat fibroid symptoms effectively.
基金Tianjin Science&Technology Plan Projects(No.17ZXMFSY00190)Tianjin Traditional Chinese Medicine Research Project,Tianjin Health and Family Planning Commission(No.2017003).
文摘Background:Single or multiple thyroid nodules and uterine fibroids are the most common benign gynecologic disease.An increasing number of breast cancer are accompanied with thyroid nodules or uterine fibroids or both of them.However,the incidence of thyroid nodules or uterine fibroids in patients with different subtypes of breast cancer is unclear.Objective:To study the incidence of thyroid nodules or uterine fibroids in patients with different subtypes of breast cancer.Methods:A retrospective cohort study conducted in the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine(China)that included 1,322 female cancer survivors who went to our hospital from January 2014 to November 2019.In this study,we evaluated the frequency of thyroid nodules and uterine fibroids in breast cancer survivors in comparison with other cancer survivors.Besides,we compare the frequency of thyroid nodules and uterine fibroids among different luminal breast cancer.Results:In this study,there were 245 breast cancer survivors,including 58 cases with thyroid nodule,52 cases with uterine fibroids,17 cases with both,152 cases with none.And 1,077 other cancer survivors were collected,including 142 cases with thyroid nodule,172 cases with uterine fibroids,25 cases with both,788 cases with none.According to statistical analysis,the incidence of thyroid nodule and uterine fibroids in breast cancer patients is significantly higher than that in non-breast cancer patients(P<0.01 and P<0.05).Between the molecular classification of breast cancer,among 245 BC patients,58 were combined with thyroid nodule,including 57 cases of luminal-A type BC and 22 cases of combined thyroid nodule;101 cases of luminal-B type BC and 20 cases of combined thyroid nodule;50 cases of HER2-positive over expression type BC and 13 cases of combined thyroid nodule;37 cases of TNBC and 3 cases of combined thyroid nodule,Patients with luminal-A BC have a higher incidence of thyroid nodules compared to other types of BC.Among 245 BC patients,there were 52 cases with uterine fibroids,including 57 cases of luminal-A type BC,5 cases with uterine fibroids;101 cases of luminal-B type BC,32 cases with uterine fibroids;50 cases of HER2-positive over expression type BC,11 cases with uterine fibroids;37 cases of TNBC,4 cases with uterine fibroids.Luminal-B breast cancer is more likely to suffer from uterine fibroids than other types of breast cancer.In addition,breast cancer patients with both thyroid nodules and uterine fibroids had significantly higher luminal-B than other subtypes.Conclusions:This study demonstrates that breast cancer women have a significantly greater incidence rate of thyroid nodules and uterine fibroids,and is higher at Luminal A or Luminal B.We consider these findings may contribute to the identification of liver channel of foot jueyin following underlying this disease association.
文摘Uterine fibroids are the most common benign tumors in gynecology.Traditional Chinese medicine treats uterine fibroids according to syndrome differentiation and treatment.The treatment of uterine fibroids has the characteristics of definitive curative effects and minor side-effects,but there are also many shortcomings,which require more in-depth research and exploration.
基金supported by the Project of Medical Key Specialty of Shanghai Municipality(grant no.:ZK2015A22)
文摘Purpose: The aim of this study was to systematically review the safety and efficacy of uterine artery embolization(UAE) versus surgery for symptomatic uterine fibroids. Materials and Methods: An electronic search of the Cochrane Library, PubMed, Embase and Web of Science databases was conducted from their inception to May 2017 for randomized controlled trials(RCTs) that assessed UAE versus surgery for the treatment of symptomatic uterine fibroids. The references of the included studies were also retrieved. Two reviewers independently screened the studies based on the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality. The meta-analysis was conducted using RevMan 5.3 software. Results: A total of seven RCTs involving 859 patients were included. The results of the meta-analysis showed a shorter hospital stay and recovery time for UAE as compared to surgery. Surgery was not reported to be better for improving health-related quality of life in any of the included studies. There were no significant differences in patient satisfaction(1-2 and 5 years), and intra-procedural complications or major complications(1 year). However, the rates of minor complications(1 year) and further interventions(2 and 5 years) were significantly higher in patients who underwent UAE rather than surgery. The rates of pregnancy and live births were significantly lower among patients who underwent UAE than surgery. Conclusion: UAE is safe and effective, and has the advantages of shorter hospital stay and recovery time as compared to surgery. However, UAE has the risk of re-intervention, and lower pregnancy and live birth rates.
文摘Purpose: To assess the safety, efficacy and effectiveness of percutaneous radiofrequency (RF) thermal ablation to reduce symptoms of uterine fibroids. Materials and Methods: 17 premenopausal women with symptomatic uterine fibroids despite conventional medical treatment were included. The assessment of symptoms and characteristics of fibroids by vaginal ultrasound, magnetic resonance imaging (MRI) and contrast enhanced ultrasound (CEUS) was performed before starting treatment and 6 months after the procedure. Successful treatment was clinically considered if patients reported a reduction in symptoms 6 months after RF myolysis. Successful treatment was also considered if the necrosis of the fibroid was greater than 50%, 6 months after treatment. Results: The baseline score on visual analogue scale (VAS) for dysmenorrhea and intermenstrual pain was 5.76 ± 3.31 and 3.0 ± 3.4, respectively. According to a score of 0 - 3, baseline bleeding during menstruation was 2.29 ± 0.92. Six months after RF myolysis, the VAS for dysmenorrhea was 2.75 ± 3.32 (p = 0.004), whereas for intermenstrual pain it was 1.38 ± 2.56 (p = 0.02). Menstrual bleeding was reduced to 1.13 ± 0.89 (p = 0.005). Clinical success of the treatment was evident in 11 (64.7%) of the 17 patients with a 95% CI [38.6%, 84.7%]. Fourteen patients underwent MRI monitoring 6 months post-myolysis. Compared to baseline fibroid volume, ultrasound and MRI volume were 57.38% and 79.66% six months after surgery, respectively. A total of 13 patients (92.86%) had radiological success from the treatment (95% CI [64.2%, 99.6%]). Conclusion: Since percutaneous RF myolysis reduces volume and symptoms of uterine fibroids, it may be considered as a valid treatment for symptomatic fibroids.
基金Supported by the Science and Technology Foundation of Shaanxi (2005K09-G6)
文摘Objective: To evaluate the outcomes of selective uterine artery embolization (SUAE) in treatment of symptomatic uterine fibroids using Color Doppler ultrasonography (CDUS). Methods: As the procedure SUAE for fibroids, prospective data of the initial 65 consecutive women treated from March 2007 to September 2009 were collected. The follow-up period from 1 week to 30 months, using questionnaires, we investigated the fibroid-related physical and psychological symptoms, and the cumulative rates of symptom control, gynecologic interventions, and complications. The volumes of uterine and uterine fibroids were calculated by CDUS pre- and post-SUAE for 6 months. And we tested the levels of internal hormone including FSH, LH and E2 before and after SUAE for 3, 6 months. Results: SUAE was performed successfully in all patients. There was no peri-operative morbidity in all procedures. Compared with pre-SUAE volumes of uterine [(322±112) cm3] and uterine fibroids [(125±46) cm3], their volumes in post-SUAE were (144±72) cm3 and (51±11) cm3 (P<0.01), and reduction rate was 58% and 61%, respectively. At 3, 6 months after SUAE, levels of FSH, LH, and E2 were not decreased than that of in pre-SUAE (P>0.05). After SUAE for 24 months, the fibroids related physical and psychological symptoms such as bleeding, pain and quality of life were significantly improved (P<0.01). 90.8% (59/65) women had resolution of symptoms and no significant post-procedural symptoms. Parts of patients discharge necrotic fibroids. 86% (34/40) complications were minor, requiring no therapy. 9.2% (6/65) had significant post-procedural symptoms, requiring therapy in hospital or out-patient department. Conclusion: SUAE contributes to a long-term significant improvement of all investigated uterine fibroid-related symptoms and markedly improves women's health-related quality of life. SUAE that no impair on changes of internal hormone, under suitable conditions, represents an attractive alternative to hysterectomy for the treatment of symptomatic fibroids and is a minimally invasive, new method of good clinical prognosis. CDUS is an effective to investigate the outcome of SUAE.
文摘Objective The aim of this study was to investigate the energy deposition in the target area of high intensity focused ultrasound(HIFU) with ultrasound-guided intra-hysteromyoma injection of ethyl alcohol absolute Methods Eighty patients with hysteromyomas were randomly divided into two groups: group HIFU(group H) and group HIFU combined with ultrasound-guided intra-hysteromyoma injectionn of ethyl alcohol absolute(group E + H). Patients in group E + H received an ultrasound-guided injection of absolute ethyl alcohol 1 h before HIFU treatment. The irradiation time, irradiation dose, energy efficiency factor(radiation energy required for ablation of a myoma per unit of volume), grey variation, pain score, and adverse reactions were compared between the two groups. An independent sample t-test was used with a twotailed P-value of < 0.05.Results The irradiation time, irradiation dose, and energy efficiency factor were significantly lower in group E + H than those in group H(P < 0.05). The hysteromyomas of patients in group E+H appeared as dominantly hyperechoic masses, and those of patients in group H appeared as hyperechoic tissue(nonmass). The incidence of adverse reactions and pain score were higher in group H than those in group E + H(P < 0.05).Conclusion Ultrasound-guided intra-hysteromyoma injection of ethyl alcohol absolute can enhance the energy deposition of HIFU in the uterine fibroids, improve the treatment efficiency, shorten the treatment time, reduce the treatment dose, and reduce the pain and complications for the patients.
文摘Introduction: Uterine leiomyomas, commonly called fibroids are benign tumors of uterine myometrium composing of smooth muscle with variable amount of connective tissue and common gynecological problem among women of reproductive age. It is the commonest tumor of the female pelvic organ. Objective: To determine the incidence of uterine fibroids, socio-demographic, clinical characteristics and outcome of uterine leiomyoma management. Material and Methods: This is a retrospective descriptive analysis of all the uterine fibroids carried out at the University of Abuja Teaching Hospital, Gwagwalada from 4th January 2013 to 31st December 2017. Data were obtained from medical records, gynaecological ward and theatre records of University of Abuja Teaching Hospital. Data were analyzed using socio-demographic, clinical characteristics and outcome of uterine leiomyoma management. Results were presented using simple percentages and ratios. Results: Uterine fibroids accounted for 6.4% of all gynaecological admissions and 21. 3% of all major gynaecological surgeries. Uterine fibroid was found to be common between the age range 30 - 39 (47.5%) years, followed by 20 - 29 (26.3%) and 40 - 49 (15.7%) years. One hundred and twenty-two (61.7%) were nulliparous while 48 (24.2%) were primiparous. Majority of the women 88 (44.4%) had tertiary education, 49 (24.7%) secondary, 48 (24.3%) primary and 13 (6.6%) had no formal education. Seventy-six (38.4%) presented with menorrhagia, abdominal mass 71 (35.9%), infertility 68 (34.3%) and abdominal pain 48 (24.2%). Most of the patients had multiple fibroids, 81 (40.9%) had intramural, 70 (35.4%) submucous and 52 (26.3%) subserous. Out of 198, 165 (83.3%) had myomectomy, 23 (11.6%) had total abdominal hysterectomy and 9 (4.6%) myomectomy and tuboplasty. Anaemia 41 (20.7%) was the commonest morbidity, followed by wound infection 12 (6.1%) and wound dehiscence 4 (2.0%). No mortality was recorded during the period under review. Conclusion: Uterine fibroid is common in our environment and usually presents with menorrhagia, abdominal mass, infertility, pelvic pain, and recurrent miscarriage. Thus healthy lifestyle should be encouraged and routine checkups conducted so as to detect and possibly treat such tumours early.
文摘The objective of this study was to investigate the clinical efficacy of carboprost tromethamine combined with mifepristone in the treatment of uterine fibroids.A total of 66 patients with uterine fibroids admitted to our hospital between April 2018 and January 2019 were selected as subjects.According to the two different treatment methods,patients were divided equally:The observation group and the control group,each group of 33 people.The oxytocin drug treatment was medicated to the control group,and the prostaglandin tromethamine combined with mifepristone was medicated to the observation group.The treatment effect,adverse reaction,operation,and uterine muscle before and after surgery were observed in these two groups:Tumor tissue progesterone receptor and estrogen receptor levels.The clinical treatment effect of the observation group was 93.94%,and the clinical treatment effect of the control group was 60.61%.The clinical treatment effect of the observation group was significantly higher than that of the control group;furthermore,the incidence of adverse reactions in the observation group in terms of rash,fatigue,nausea,and vomiting was much lower than the control group and could observe a significant difference.Finally,in observation group,the amount of intraoperative blood loss,operation time,and hospitalization time was better than those of the control group.The progesterone receptor and estrogen receptor levels in the uterine fibroid tissue after surgery should also be better than the control group,and it is worth to make a further comparison.Carboprost tromethamine combined with mifepristone is effective in the treatment of uterine fibroids and can be further developed.
文摘Objective:To investigate the effect of Guizhi Fuling Capsule on sex hormones and tumor markers in patients with uterine fibroids, and observe its clinical efficacy.Methods: A total of 120 patients with uterine fibroids who were treated in our hospital from August 2016 to August 2017 were selected according to the order of treatment and divided into observation group and control group, 60 cases each. Mifepristone was administered to the control group and mifepristone combined with Guizhi Fuling Capsules was administered to the observation group. The levels of hemoglobin, vascular endothelial growth factor (VEGF), sex hormones, tumor markers, and inflammatory factors before and after treatment were compared between the two groups.Result:The levels of hemoglobin, vascular endothelial growth factor (VEGF), sex hormones, tumor markers, and inflammatory factors before and after treatment were compared between the two groups. After treatment, hemoglobin levels increased significantly in the two groups, VEGF, sex hormones FSH, LH and E2, tumor markers HE4, CA125, inflammatory cytokines TNF-α and IFN-γ levels decreased significantly. The hemoglobin level of the observation group was (117.09±11.51) g/L higher than that of the control group , and the level of VEGF was (0.69±0.06) pg/mL lower than that of the control group. The levels of sex hormone FSH, LH and E2 in the observation group were (15.87±1.56) U/L, (10.69±1.06) U/L and (4.95±0.51) pmol/L lower than those of the control group. The levels of HE4, CA125, TNF-α and IFN-γ gamma in the observation group were (52.47±5.24) pmol/L, (15.46±1.53) U/mL, (40.41±4.05) and (16.72±1.62) pg/mL lower than those of the control group.Conclusion:Guizhi Fuling Capsule can significantly improve the level of sex hormones and tumor markers, relieve inflammatory stress and improve the therapeutic effect.
文摘Objective: To study the effect of dexmedetomidine in high intensity focused ultrasound treatment of uterine fibroids on pain degree, pain mediator and stress mediator secretion as well as stress signal molecule expression. Methods: 78 patients with uterine fibroids who received high intensity focused ultrasound treatment in Shaanxi Second Provincial People's Hospital between February 2015 and February 2018 were selected as the research subjects and randomly divided into the Dex group who accepted dexmedetomidine + fentanyl + midazolam anesthesia and the control group who accepted fentanyl + midazolam anesthesia. The pain degree was assessed 1 day and 3 d after surgery;the secretion of pain mediators and stress mediators in serum as well as the expression levels of stress signaling molecules in peripheral blood were measured before surgery and 3 d after surgery. Results: 1 d and 3 d after surgery, the NRS pain scores of Dex group were significantly lower than those of control group;3 d after surgery, serum SP, BK, 5-HT, IL-6, IL-8, NE, COR, ACTH and MDA contents as well as peripheral blood NF-κB, p38MAPK, NOX4 and Nrf2 expression of both groups of patients were higher than those before surgery whereas serum SOD and HO-1 contents as well as peripheral blood Keap1 expression were lower than those before surgery, and serum SP, BK, 5-HT, IL-6, IL-8, NE, COR, ACTH and MDA contents as well as peripheral blood NF-κB, p38MAPK, NOX4 and Nrf2 expression of Dex group 3 d after surgery were lower than those of control group whereas serum SOD and HO-1 contents as well as peripheral blood Keap1 expression were higher than those of control group. Conclusion: The application of dexmedetomidine in high intensity focused ultrasound treatment of uterine fibroids can reduce the degree of postoperative pain and stress response.
文摘Objective:To investigate the effects of Gongliuxiao Capsule on inflammatory factors, tumor markers, sex hormones and vascular endothelial function in patients with uterine fibroids. Methods:130 patients with uterine fibroids admitted to our hospital from October 2015 to March 2017 were enrolled. According to the treatment, they were divided into single treatment group and combined medication group, with 65 cases in each group. The changes of inflammatory factors, tumor markers, sex hormones and vascular endothelial function were compared before and after treatment in the two groups.Results: There were no significant differences in the levels of sex hormones, inflammatory factors, tumor markers and vascular endothelial function between the two groups (P>0.05). The levels of sex hormones E2, P, FSH and LH, the levels of inflammatory factors TNF-α, MMP-9 and IGF-1, tumor markers CA125, CA19-9 and vascular endothelial function VEGF and b-FGF were significantly lower in the two groups (P<0.05). The levels of E2, P, FSH and LH in the combined drug groupswere (154.12±16.20) pmol/L, (9.12±1.02) μg/L, (13.84±1.42) U/L and (12.77±1.36) U/L, respectively,which were significantly lower than the single drug group level (P<0.05). The levels of CA125 and CA19-9 in the combined drug group were (27.89±2.88) U/mL and (28.09±3.04) U/mL, respectively, which were significantly lower than the single drug group (P<0.05). The levels of TNF-α, MMP-9 and IGF-1 in the combined drug group were (24.16±2.63) ng/L, (159.22±16.82) μg/L and (69.75±7.09) μg/L, respectively, which were significantly lower than the single drug group(P<0.05). The levels of VEGF and b-FGF in the combination group were (138.29±14.32) μg/L and (98.59±10.02) μg/L, respectively, which were significantly lower than the single drug group (P<0.05).Conclusion:Mifepristone combined with Gongliuxiao Capsule can alleviate endocrine disorders, relieve inflammatory stress response and improve vascular endothelial function in patients with uterine fibroids. It is worthy of clinical application.
