促性腺激素释放激素激动剂联合曼月乐治疗保守性手术后中重度子宫内膜异位症的疗效分析  

Efficacy of GnRH Agonist Combined with Levonorgestrel Releasing Intrauterine System in the Treatment of Moderate to Severe Endometriosis after Conservative Surgery

作　　者：彭艳[1] 姚吉龙[1] 刘剀[1] 孟喆[1] 

机构地区：[1]南方医科大学附属深圳市妇幼保健院,深圳518000

出　　处：《生殖与避孕》2013年第7期491-495,共5页Reproduction and Contraception

基　　金：深圳市科技工贸和信息委立项课题;课题编号201103182

摘　　要：目的:探讨促性腺激素释放激素激动剂(GnRHa)联合曼月乐治疗中重度子宫内膜异位症(EMs)保守性手术后的疗效。方法:选择腹腔镜保守性手术后中重度EMs、无生育要求的患者43例,随机分为2组,试验组23例,术后使用GnRHa联合曼月乐治疗,对照组20例,术后单纯使用GnRHa治疗。随访12个月,比较手术前、手术后3个月、6个月、9个月和12个月疼痛评分、CA125值和复发率。结果:试验组和对照组中,术后各时间点的疼痛评分均低于术前(P<0.05);试验组中术后各时间点的疼痛评分无统计学差异;对照组中术后12个月疼痛评分均高于术后3个月、6个月和9个月(P<0.05);在术后12个月试验组的疼痛评分低于对照组(P<0.05)。试验组和对照组中,术后各时间点CA125值均低于术前(P<0.05);试验组中术后各时间点CA125值无统计学差异。对照组中术后12个月CA125值均显著高于术后3个月、6个月和9个月(P<0.05)。术后12个月试验组的CA125低于对照组(P<0.05)。试验组的复发率为0.0%;对照组的复发率为15.0%。结论:GnRHa联合曼月乐治疗保守性手术后中、重度EMs,可以长时间缓解疼痛,降低术后复发率,是一种有效的巩固治疗方法。Objective：To explore the efficacy of GnRH agonist（GnRHa） combined with levonorgestrel intrauterine system（LNG-IUS） in the treatment of moderate to severe endometrosis（EMs） after conservative surgery.Methods：Forty-three patients with moderate to severe EMs after conservative surgery were randomly divided into 2 groups：experimental group in which 23 women were given GnRHa and LNG-IUS therapy,and control group in which 20 women were given GnRHa therapy only.The follow-up period was 12 months.The mean visual analogue scale（VAS） scores of their pains,serum CA125 levels,recurring rate between the two groups and between pre-therapy and post-therapy were compared.Results：In two groups,significant differences（P0.05） existed in VAS scores at the end of 3-month,6-month,9-month and 12-month treatment when compared with the preoperative situation.In experimental group,there were no differences in VAS scores among difference times after post-operation.In control group,the VAS score at the end of 12-month treatment was significantly higher than that at the end of 3-month,6-month and 9-month treatment（P0.05）.At the end of 12-month treatment,the VAS scores in experimental group were significantly lower than those in control group.In two groups,significant differences（P0.05） existed in serum CA125 at the end of 3-month,6-month,9-month and 12-month treatment when compared with the preoperative situation.In experimental group,there were no differences in the value of serum CA125 among difference times after post-operation.In control group,the value of serum CA125 at the end of 12-month treatment was significantly higher than that at the end of 3-month,6-month and 9-month treatment（P0.05）.At the end of 12-month treatment,the value of serum CA125 in experimental group was significantly lower than that in control group.After 1-year treatment,the recurrence rate of experimental group was obviously lower than that in control group（0.0% vs 15.0%,P0.05）.Conclusion：GnRHa combined with LNG-IUS is

关 键 词：子宫内膜异位症(EMs) 促性腺激素释放激素激动剂(GnRHa) 曼月乐 疼痛 

分 类 号：R713.4[医药卫生—妇产科学]