GnRH-a联合左炔诺孕酮宫内缓释系统治疗子宫腺肌病的效果  

Effect of GnRH-a combined with lcvonorgcstrcl intrauterine sustained release system in the treatment of adenomyosis

作　　者：王海燕[1] Wang Haiyan(Department of Obstetrics and Gynecology,Xuzhou Maternal and Child Health Hospital,Xuzhou 221000,China)

机构地区：[1]徐州市妇幼保健院妇产科,江苏徐州221000

出　　处：《实用妇科内分泌电子杂志》2021年第36期37-40,共4页Electronic Journal of Practical Gynecological Endocrinology

摘　　要：目的探讨促性腺激素释放激素激动剂(GnRH-a)联合左诀诺孕酮宫内缓释系统治疗子宫腺肌病的效果。方法选择本院收治的子宫腺肌病患者104例为研究对象,根据随机数字表法分为对照组及研究组,每组52例。对照组采用GnRH-a注射治疗,研究组在对照组基础上放置左诀诺孕酮宫内缓释系统治疗,比较两组治疗效果。结果治疗前,两组痛经视觉模拟评分(VAS)及月经失血图形分析评分(PBAC)比较,差异无统计学意义(P>0.05);治疗1、3、6、12个月后,两组VAS评分及PBAC评分均明显降低,且研究组各时点VAS、PBAC评分均低于对照组,差异有统计学意义(P<0.05);两组各时点月经周期比较,差异无统计学意义(P>0.05)。治疗前,两组子宫体积、血红蛋白水平、子宫内膜厚度及血清糖类抗原125(CA125)水平比较,差异无统计学意义(P>0.05);治疗1、3、6、12个月后,两组子宫内膜厚度及CA125水平均下降,子宫体积均增大,且研究组各时点子宫内膜厚度及CA125水平均低于对照组,研究组治疗6、12个月后的子宫体积均大于对照组;治疗1个月后,两组血红蛋白水平均高于治疗前,且研究组血红蛋白水平高于对照组,差异有统计学意义(P<0.05)。研究组不良反应发生率为5.77%,与对照组的9.62%比较,差异无统计学意义(P>0.05)。结论采用GnRH-a联合左诀诺孕酮宫内缓释系统治疗子宫腺肌病,能减轻患者痛经程度,改善其月经情况,减缓子宫进行性增大,改善患者血红蛋白水平及子宫内膜厚度,降低血清CA125水平,且安全性较高,值得推广使用。Objective To investigate the efficacy of gonadotropin-releasing hormone agonist(GnRH-a)combined with lemogenorgestrel intrauterine sustained release system in the treatment of adenomyosis.Methods A total of 104 cases of adenomyosis patients admitted to our hospital were selected as research objects and divided into a control group and a study group according to random number table method,with 52 cases in each group.The control group was treated with GnRH-a injection,and the study group was treated with legimogestrone intrauterine sustained release system on the basis of the control group.The therapeutic effect of the two groups was compared.Results Before treatment,there were no significant differences in pain visual analog scale(VAS)scores and pictorial blood loss assessment chart(PBAC)scores between the two groups(P>0.05);after 1,3,6 and 12 months of treatment,the VAS scores and PBAC scores of both groups were significantly decreased,and the VAS and PBAC scores of the study group were lower than those of the control group at each time point,the differences were statistically significant(P<0.05);there was no significant difference in menstrual cycle between the two groups at each time point(P>0.05).Before treatment,there were no significant differences in uterine volume,hemoglobin level,endometrial thickness and serum carbohydrate antigen 125(CA125)level between the two groups(P>0.05);after 1,3,6 and 12 months of treatment,the endometrial thickness and CA125 levels decreased and uterine volume increased in both groups,and the endometrial thickness and CA125 levels in the study group were lower than those in the control group at all time points,and the uterine volume in the study group was greater than that in the control group after 6 and 12 months of treatment,after 1 month of treatment,the hemoglobin level in both groups was higher than that before treatment,and the hemoglobin level in the study group was higher than that in the control group,the differences were statistically significant(P<0.05).The incidence

关 键 词：促性腺激素释放激素激动剂 左诀诺孕酮宫内缓释系统 子宫腺肌病 痛经 月经量 月经周期 子宫体积 

分 类 号：R711.74[医药卫生—妇产科学]