探讨子宫内膜异位症术后GnRH-a联合地诺孕素序贯治疗的应用价值  

Exploring the Application Value of Postoperative GnRH-a Combined with Dienogest Sequential Therapy for Endometriosis

作　　者：张会娟 ZHANG Huijuan(Department of Gynecology,Juye County People's Hospital,Heze,Shandong Province,274900 China)

机构地区：[1]巨野县人民医院妇科,山东菏泽274900

出　　处：《系统医学》2023年第19期168-171,共4页Systems Medicine

摘　　要：目的调查子宫内膜异位症术后促性腺激素释放激素激动剂(gonadotropin-releasing hormone agonist,GnRH-a)+地诺孕素序贯治疗的价值。方法选取2021年5月—2023年6月巨野县人民医院妇科收治的86例子宫内膜异位症患者作为研究对象,均行手术治疗,根据双盲法分为比照组、探究组,每组43例。比照组在术后行GnRH-a治疗,探究组增加地诺孕素序贯治疗。比较两组性激素、抗原水平,观察疼痛情况,统计有效率。结果治疗后探究组雌二醇(101.35±7.69)pmol/L、孕酮(0.39±0.12)nmol/L均低于比照组,差异有统计学意义(t=11.880、6.445,P<0.05)。治疗后探究组糖类抗原199、糖类抗原125水平均低于比照组,差异有统计学意义(t=9.489、10.415,P<0.05)。治疗后探究组经期痛、盆腔痛评分均低于比照组,差异有统计学意义(t=7.915、5.509,P<0.05)。探究组有效率高于比照组,一年内复发率低于比照组,差异有统计学意义(χ^(2)=4.962、5.108,P<0.05)。结论GnRH-a+地诺孕素序贯治疗的方案可调节激素水平,有效降低抗原指标,减轻痛经等问题,有效性高,复发风险低,可在子宫内膜异位症术后使用。Objective To investigate the value of postoperative gonadotropin-releasing hormone agonist(GnRH-a)+dienogest sequential therapy for endometriosis.Methods A total of 86 cases of endometriosis patients admitted to the gynecology department of Juye County People's Hospital from May 2021 to June 2023 were selected as the study objects,all of whom underwent surgical treatment.They were divided into comparison group and exploration group according to double-blind method,with 43 cases in each group.The comparison group was treated with GnRH-a after surgery,and the study group was given sequential treatment with dinorgestrel.The levels of sex hormone and antigen were compared between the two groups,and the pain was observed.Results After treatment,estradiol(101.35±7.69)pmol/L and progesterone(0.39±0.12)nmol/L in the exploration group were lower than those in the comparison group,and the differences were statistically significant(t=11.880,6.445,P<0.05).After treatment,the levels of carbohydrate antigen 199 and carbohydrate antigen 125 in the exploration group were lower than those in the comparison group,and the differences were statistically significant(t=9.489,10.415,P<0.05).After treatment,the scores of menstrual pain and pelvic pain in the study group were lower than those in the comparison group,and the differences were statistically significant(t=7.915,5.509,P<0.05).The effective rate of the inquiry group was higher than that of the comparison group,and the recurrence rate within one year was lower than that of the comparison group,with statistical significance(χ^(2)=4.962,5.108,P<0.05).Conclusion The regimen of GnRH-a+dienogest sequential treatment can regulate hormone levels,effectively reduce antigenic indexes and alleviate problems such as dysmenorrhea,with high effectiveness and low risk of recurrence,and it can be used after endometriosis surgery.

关 键 词：子宫内膜异位症手术 地诺孕素 抗原水平 促性腺激素释放激素激动剂 使用价值 序贯治疗 

分 类 号：R711.71[医药卫生—妇产科学]