DNG和COC用于卵巢子宫内膜异位囊肿剥除术后控制复发的疗效比较  

Comparison of the efficacy of using dienogest versus combined oral contraceptive to control recurrence after ovarian endometrioma cystectomy

作　　者：郑飏飞 池梅 刘玉立 刘宇 杜欣 ZHENG Yangfei;CHI Mei;LIU Yuli;LIU Yu;DU Xin(Medical College of Wuhan University of Science and Technology,Wuhan 430070,Hubei,China;Department of Gynaecology,Hubei Maternal and Child Health Hospital,Wuhan 430070,Hubei,China)

机构地区：[1]武汉科技大学医学院,武汉430070 [2]湖北省妇幼保健院妇科,武汉430070

出　　处：《中国性科学》2024年第3期74-77,共4页Chinese Journal of Human Sexuality

基　　金：2019湖北省卫生健康委第一批联合项目(WJ2019H190)。

摘　　要：目的比较地诺孕素(DNG)和复方口服避孕药(COC)用于卵巢子宫内膜异位囊肿剥除术后长期管理的疗效。方法选取2020年2月至2021年8月在湖北省妇幼保健院行腹腔镜卵巢子宫内膜异位囊肿剥除术的58例患者作为研究对象,术后给予促性腺激素释放激素激动剂(GnRH-a)治疗3个月。采用随机数字表法将研究对象分为DNG组(n=28)和COC组(n=30),分别服用DNG和COC 12个月。比较两组痛经视觉模拟评分法(VAS)评分、血清糖类抗原125(CA125)、雌二醇(E_(2))、抗米勒管激素(AMH)、囊肿复发情况、月经模式、骨密度(BMD)、不良反应及成本-效果比(C/E)。结果两组痛经VAS评分、CA125、AMH比较,差异无统计学意义(P>0.05);DNG组E_(2)、股骨及腰椎BMD高于COC组(P<0.05);两组均无囊肿复发;两组不良反应总发生率比较,差异无统计学意义(P>0.05);COC组C/E低于DNG组(P<0.05)。结论DNG控制卵巢子宫内膜异位囊肿剥除术后复发的效果与COC相当,但对BMD和E_(2)的影响可能小于COC,但价格高于COC。Objective To compare the clinical effects between dienogest(DNG)and combined oral contraceptive(COC)in long-term management after ovarian endometrioma cystectomy.Methods A total of 58 patients who underwent laparoscopic ovarian endometrioma cystectomy in Hubei Maternal and Child Health Hospital from February 2020 to August 2021 were selected as the study subjects and were treated with gonadotropin-releasing hormone agonist(GnRH-a)for 3 months after the operation.They were divided into DNG group(n=28)and COC group(n=30)by random number table method,and were treated with DNG and COC for 12 months respectively.The visual analog scale(VAS)score of dysmenorrhea,serum carbohydrate antigen 125(CA125),estradiol(E_(2)),anti-Müllerian hormone(AMH),endometrioma recurrence condition,menstrual pattern,bone mineral density(BMD),adverse reactions and cost-effectiveness ratio(C/E)were compared between the two groups.Results There was no statistical significance differences in dysmenorrhea VAS score,CA125,AMH between the two groups(P>0.05).E_(2),femoral and lumbar BMD in DNG group were higher than those in COC group(P<0.05),there was no recurrence of endometrioma in both two groups.There was no significant difference in the total incidence of the adverse reactions between the two groups(P>0.05).COC group has a lower C/E than that of DNG group(P<0.05).Conclusions The effect of DNG on controlling the recurrence after ovarian endometrioma cystectomy is comparable to that of COC,but its influence on BMD and E_(2) may be less than that of COC,with a higher price than that of COC.

关 键 词：子宫内膜异位囊肿 地诺孕素 复方口服避孕药 疗效 

分 类 号：R711[医药卫生—妇产科学]