醋酸戈舍瑞林缓释植入剂对妇科肿瘤术后化疗患者卵巢功能影响的临床研究  

Effect of Goserelin Acetate Sustained-release Depo on Ovarian Function in Patients with Gynecologic Oncology after Chemotherapy

作　　者：张晓凤[1] ZHANG Xiaofeng(：Maoming People’s Hospital,Maoming 525000,Chin)

机构地区：[1]广东省茂名市人民医院,广东茂名525000

出　　处：《中国医学创新》2018年第21期5-9,共5页Medical Innovation of China

基　　金：茂名市科技计划项目(2015029)

摘　　要：目的:探讨醋酸戈舍瑞林缓释植入剂在妇科肿瘤术后化疗患者中的应用效果及对卵巢功能的影响。方法:选择2014年8月-2015年7月本科室收治的妇科肿瘤术后化疗患者152例,按照随机数字表法分为对照组(n=76例)和观察组(n=76例)。对照组采用常规方法化疗,观察组在对照组基础上联合醋酸戈舍瑞林缓释植入剂治疗。采用免疫化学发光法测定两组手术前后卵泡雌激素(FSH)、雌二醇(E_2)及黄体生成素水平;采用彩色多普勒超声诊断仪对两组治疗前、后卵巢动脉血流指标PI、RI及S/D水平进行测定,记录并统计两组化疗后月经生育及绝经相关症状;记录并统计两组治疗后潮热出汗、易激动、失眠及性交痛发生率,比较两组临床疗效及对卵巢功能的影响。结果:观察组治疗6周期后FSH、E2及LH水平,均低于治疗前(P<0.05);对照组治疗6周期后FSH和LH水平,均高于治疗前(P<0.05);对照组治疗6周期后E_2水平,低于治疗前(P<0.05);观察组治疗6周期后FSH、E_2及LH水平,均低于对照组(P<0.05);观察组治疗6周期后卵巢血流学参数PI、RI及S/D水平,均低于对照组(P<0.05);观察治疗6周期后月经复潮天数为(35.41±7.25)d,短于对照组的(102.53±4.28)d(P<0.05)。观察组治疗6周期后月经稀发、经量减少及闭经发生率,均低于对照组(P<0.05);观察组治疗6周期后潮热出汗、易激动、失眠及性交痛发生率,均低于对照组(P<0.05);观察组与对照组均对保留生育功能者进行随访观察,观察组治疗后2~3年足月娩出率高于对照组(P<0.05);观察组治疗后2~3年自然流产率、异位妊娠率,均低于对照组(P<0.05)。结论:在常规化疗基础上联合醋酸戈舍瑞林缓释植入剂用于妇科肿瘤术后化疗患者中效果理想,有助于改善患者卵巢功能,能降低更年期相关症状,提高化疗后患者的妊娠率,值得推广应用。Objective：To investigate the effect of Goserelin Acetate Sustained-release Depo on postoperative chemotherapy in gynecologic oncology and its effect on ovarian function.Method：A total of 152 patients undergoing gynecologic oncology postoperative chemotherapy were selected from August 2014 to July 2017.Acording to randomized numerical methods they were divided into control group（n=76） and observation group（n=76）.The control group was treated with conventional chemotherapy.The observation group was treated with Goserelin Acetate Sustained-release Depo on the basis of the control group.The levels of follicular-derived estrogen（FSH）,estradiol（E_2） and luteinizing hormone（LH） in two groups before and after operation were measured by immunochemical chemiluminescence.The color Doppler echocardiography was used to measure the changes of ovarian arterial blood flow index,RI and S/D levels.The symptoms of menopause and menopause after 2 cycles of chemotherapy were recorded and statistically analyzed.The incidence of hot flashes,irritability,insomnia and pain after hot flashes,efficacy and ovarian function of two groups were recorded and statistically compared. Result：The levels of FSH,E_2 and LH in the observation group after 6 cycles were lower than those of before treatment（P〈0.05）.The levels of FSH and LH in the control group after 6 cycles were higher than those of before treatment（P〈0.05）.The levels of FSH,E_2 and LH in the observation group after 6 cycles of treatment were lower than those of the control group（P〈0.05）.After 6 cycles of treatment,the ovarian blood flow parameters PI,RI and S/D levels were lower than those of the control group（P〈0.05）.After 6 weeks of treatment,the days of menstrual cramps were（35.41±7.25）d,shorter than those of the control group（102.53 ± 4.28）d（P〈0.05）.After 6 weeks of treatment,the observation group had less menstrual flow,decreased menstruation and amenorrhea,which were lower than those of the control group（P〈0.05

关 键 词：醋酸戈舍瑞林缓释植入剂 妇科肿瘤 术后化疗 卵巢功能 彩色多普勒超声诊断仪 免疫化学发光法 

分 类 号：R737.3[医药卫生—肿瘤]