腹壁子宫内膜异位症术后用药与复发的临床研究  

Clinical study on postoperative medication and recurrence of abdominal wall endometriosis

作　　者：赵高娃 宋力猛 付春红 龙梅 Zhao Gaowa;Song Limeng;Fu Chunhong(Department of Obstetrics and Gynecology,Inner Mongolia Autonomous Region People's Hospital,Hohhot 010010,China)

机构地区：[1]内蒙古自治区人民医院妇产科,呼和浩特010010

出　　处：《中华保健医学杂志》2023年第3期297-300,共4页Chinese Journal of Health Care and Medicine

摘　　要：目的 探讨腹壁子宫内膜异位症(AWE)术后用药与复发之间的关系并分析复发的影响因素。方法 回顾性选取2016年1月~2021年4月内蒙古自治区人民医院住院手术治疗的AWE患者84例,收集资料包括患者的发病年龄、潜伏期、病灶大小、深浅、病灶个数、术后疗效、术后是否应用促性腺激素释放激素激动剂(GnRH-a)、避孕药、术后复发情况,以及用药后的不良反应及对月经的影响等,并对以上数据进行统计分析。结果 研究共收集样本84例,其中83例(98.8%)有剖宫产手术史,1例无腹部手术史。术后未用药组29例(占34.5%),GnRH-a药物组44例(占52.4%),避孕药组11例(占13.1%)。用药后不良反应的为20例(占23.8%),月经异常的有11例(占13.1%)。GnRH-a组的不良反应率(40.9%)高于避孕药组(18.2%),月经异常率(40.9%)高于避孕药组(18.2%),差异有统计学意义(P <0.05)。避孕药组的复发率(27.3%)高于GnRH-a药物组(6.8%)和未用药组(3.4%),差异有统计学意义(P <0.05)。结论 AWE使用GnRH-a类药物或避孕药不能降低复发率,且易出现药物不良反应及月经异常,故对于单纯腹壁子宫内膜异位症患者,不建议术后常规使用GnRH-a类药物及避孕药预防复发。发病年龄、病灶大小、病灶部位、病灶侵及深度均不作为影响复发的因素,手术彻底切除是唯一有效的预防手段。Objective To explore the relationship between postoperative medication and recurrence of abdominal wall endometriosis and analyze the influencing factors of recurrence.Methods From January 2016 to April 2021,84 patients with AWE were hospitalized in the Inner Mongolia People's Hospital.The data were retrospectively analyzed,including the age of onset,incubation period,size,depth,number of lesions,postoperative curative effect,whether gonadotropin-releasing hormone agonist(GnRH-a)was used after operation,contraceptive pills,postoperative recurrence,adverse reactions and their effects on menstruation,etc.The above data were statistically analyzed.Results A total of 84 cases were collected in this study,of which 83 cases(98.8%)had a history of cesarean section and 1 case had no history of abdominal surgery.After operation,there were 29 cases(34.5%)in the nondrug group,44 cases(52.4%)in the GnRH-a drug group and 11 cases(13.1%)in the contraceptive group.20 cases(23.8%)had adverse reactions and 11 cases(13.1%)had abnormal menstruation.The adverse reaction rate of GnRH-a group(40.9%)was higher than that of contraceptive group(18.2%)(P<0.05).The abnormal menstrual rate of GnRH-a group(40.9%)was higher than that of contraceptive group(18.2%)(P=0.003).The recurrence rate of contraceptive group(27.3%)was higher than that of GnRH-a group(6.8%)and that of non-drug group(3.4%)(P<0.05).Conclusion The use of GnRH-a drugs or contraceptives for AWE can not reduce the recurrence rate,and adverse drug reactions and menstrual abnormalities are easy to occur.Therefore,it is not recommended to routinely use GnRH-a drugs and contraceptives after operation for patients with simple abdominal endometriosis to prevent recurrence.Age,size,location and depth of the lesion are not the factors that affect the recurrence,and complete surgical resection is the only effective preventive measure.

关 键 词：腹壁子宫内膜异位症 促性腺激素释放激素激动剂 避孕药 复发 

分 类 号：R711[医药卫生—妇产科学]