左炔诺孕酮宫内缓释系统联合促性腺激素释放激素激动剂治疗腹腔镜手术后重度子宫内膜异位症患者的临床疗效  

Clinical efficacy of levonorgestrel-releasing intrauterine system combined with gonadotropin releasing hormone agonist in the treatment of patients with severe endometriosis after laparoscopic surgery

作　　者：周晓艳 刘清源 刘爽 肖雪 ZHOU Xiaoyan;LIU Qingyuan;LIU Shuang;XIAO Xue(Chaoyang Second Hospital,Chaoyang,Liaoning,122000,China)

机构地区：[1]朝阳市第二医院,辽宁朝阳122000

出　　处：《当代医学》2023年第6期14-17,共4页Contemporary Medicine

摘　　要：目的探讨左炔诺孕酮宫内缓释系统(LNG-IUS)联合促性腺激素释放激素激动剂(GnRH-a)辅助治疗腹腔镜手术后重度子宫内膜异位症患者的临床疗效及对血清CA125水平和卵巢储备功能的影响。方法回顾性分析2018年7月至2021年6月于本院行腹腔镜手术的80例重度子宫内膜异位症患者的临床资料,依据辅助治疗方法不同分为联合组与单一组,每组40例。联合组给予LNG-IUS联合GnRH-a辅助治疗,单一组给予单独GnRH-a治疗,比较两组症状评分、骨密度、血清性激素水平、血清糖类抗原125(CA125)水平、卵巢储备功能、临床疗效、不良反应发生情况及复发情况。结果治疗后,联合组痛经、性交痛评分均低于单一组,骨密度大于单一组,差异有统计学意义(P<0.05)。治疗后,联合组血清促黄体生成素(LH)、促卵泡素(FSH)、雌二醇(E2)水平均低于单一组,差异有统计学意义(P<0.05)。治疗后,联合组血清CA125水平低于单一组,差异有统计学意义(P<0.05);但两组卵巢基质动脉血流收缩期峰值(PSV)、卵巢窦状卵泡数(FO)比较差异无统计学意义。联合组治疗总有效率为90.00%,高于单一组的67.50%,差异有统计学意义(P<0.05)。联合组不良反应发生率、复发率分别为7.50%、10.00%,均低于单一组的25.00%、32.50%,差异有统计学意义(P<0.05)。结论与单独GnRH-a辅助治疗比较,LNG-IUS联合GnRH-a辅助治疗腹腔镜手术后重度子宫内膜异位症的疗效更显著,能有效降低患者血清CA125水平,改善患者性激素水平,且不会影响患者的卵巢储备功能,还可降低不良反应发生率及复发率,值得临床推广应用。Objective To investigate the clinical efficacy of levonorgestrel-releasing intrauterine system(LNG-IUS)combined with gonadotropin releasing hormone agonist(GnRH-a)in the treatment of patients with severe endometriosis after laparoscopic surgery,and the effects on serum CA125 level and ovarian reserve function.Methods The clinical data of 80 patients with severe endometriosis who underwent laparoscopic surgery in our hospital from July 2018 to June 2021 were analyzed retrospectively,and they were divided into combined treatment group and separate treatment group according to different auxiliary treatment methods,with 40 cases in each group.The combined treatment group was treated with LNGIUS combined with GnRH-a adjuvant therapy,and the single treatment group was treated with GnRH-a adjuvant therapy alone,the symptom score,bone mineral density,serum sex hormone level,serum carbohydrate antigen 125(CA125)level,ovarian reserve function,clinical efficacy,adverse reactions and recurrence were compared between the two groups.Results After treatment,the scores of dysmenorrhea and sexual intercourse pain in the combined treatment group were lower than those in the single treatment group,and the bone mineral density was larger than that in the single treatment group,the differences were statistically significant(P<0.05).After treatment,the levels of serum luteinizing hormone(LH),follicle stimulating hormone(FSH)and estradiol(E2)in the combined treatment group were lower than those in the single treatment group,and the differences were statistically significant(P<0.05).After treatment,the serum the level of CA125 in the combined treatment group was lower than that in the single treatment group,and the difference was statistically significant(P<0.05);however,there was no significant difference in the peak systolic value of ovarian stromal artery(PSV)and the number of antral follicles count(FO)between the two groups.The total effective rate in the combined treatment group was 90.00%,which was higher than 67.50%in the single

关 键 词：左炔诺孕酮宫内缓释系统 促性腺激素释放激素激动剂 重度子宫内膜异位症 糖类抗原125 卵巢储备功能 

分 类 号：R711.71[医药卫生—妇产科学]