左炔诺孕酮宫内节育系统联合腹腔镜治疗Ⅲ/Ⅳ期子宫内膜异位症  

Effect of levonorgestrel intrauterine contraceptive system combined with laparoscopy for treating patients with stage Ⅲ/Ⅳ endometriosis

作　　者：董雪[1] 黄冬梅[1] 王武亮[1] DONG Xue;HUANG Dongmei;WANG Wuliang(The Second Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan Province,450000)

机构地区：[1]郑州大学第二附属医院,450000

出　　处：《中国计划生育学杂志》2021年第6期1114-1116,共3页Chinese Journal of Family Planning

摘　　要：目的:探讨左炔诺孕酮宫内节育系统联合腹腔镜保守手术治疗Ⅲ/Ⅳ期子宫内膜异位症(EMs)效果。方法:以2018年7月-2019年12月本院行腹腔镜保守手术治疗的Ⅲ/Ⅳ期EMs患者90例,根据生育需求分为观察组和对照组各45例,观察组放置左炔诺孕酮宫内节育器治疗,对照组行醋酸亮丙瑞林皮下注射治疗,治疗后6个月时用视觉模拟评分法评估两组患者痛经、盆腔痛程度,统计EMs复发率及不良反应。结果:治疗后观察组痛经(7.2±4.0分)及月经量(108.2±13.4ml)与对照组(8.1±4.1分、106.8±14.0ml)比较无差异(P>0.05);经间期盆腔痛得分观察组(6.1±1.1分)低于对照组(6.6±1.3分)(P<0.05);复发率观察组(6.7%)和对照组(20.0%)无差异(P>0.05);观察组不良反应发生率(28.9%)低于对照组(48.9%)(P<0.05)。结论:左炔诺孕酮宫内节系统联合腹腔镜保守手术能有效减少Ⅲ/Ⅳ期EMs患者经间期盆腔痛和不良反应发生。Objective:To explore the therapeutic effect of levonorgestrel intrauterine system combined with laparoscopic conservative surgery in patients with stage Ⅲ/Ⅳ endometriosis,and to provide reference for clinical treatment decisions.Methods:90 patients with stage Ⅲ/Ⅳ endometriosis who underwent laparoscopic conservative surgery were selected as observation objects from July 2018 to December 2019,and they were divided into two groups(45 cases in each group)according to the demand of baby.The women in the observation group were given levonorgestrel intrauterine contraceptive system,and the women in the control group were treated with leuprolide acetate subcutaneous injection.The dysmenorrhea degree and pelvic pain situation of the women in the two groups were evaluated by visual analogue score.The rates of endometriosis recurrence and adverse reaction of the women in the two groups were statistics analyzed.Results:After treatment,there were no significant differences in dysmenorrhea degree(7.2±4.0 points vs.8.1±4.1 points)and menstrual volume(108.2±13.4 ml vs.106.8±14.0 ml)of the women between the two groups(P>0.05).The score of pelvic pain(6.1±1.1 points)during menstrual interval of the women in the observation group was significant lower than that(6.6±1.3 points)of the women in the control group(P<0.05).The endometriosis recurrence rate of the women in the observation group(6.7%)had no significant different from that(20.0%)of the women in the control group(P>0.05).The incidence of adverse reaction(28.9%)of the women in the observation group was significant lower than that(48.9%)of the women in the control group(P<0.05).Conclusion:Levonorgestrel intrauterine contraceptive system combined with laparoscopic conservative surgery for treating women with stage Ⅲ/Ⅳ endometriosis can effectively reduce the incidences of their menstrual interval pelvic pain and adverse reaction.

关 键 词：子宫内膜异位症 腹腔镜手术 左炔诺孕酮宫内节育器系统 醋酸亮丙瑞林 复发 盆腔痛 

分 类 号：R713.4[医药卫生—妇产科学]