腹腔镜子宫动脉阻断联合子宫腺肌瘤病灶切除术后应用米非司酮与左炔诺孕酮宫内缓释系统的疗效与安全性对比  

Comparison of the Efficacy and Safety of Mifepristone and Levonorgestrel Intrauterine Extended-release System After Laparoscopic Uterine Artery Blockade Combined with Focal Resection of Uterine Adenomyoma

作　　者：凌静[1] Ling Jing(Department of Obstetrics and Gynecology,Jiangyin People's Hospital,Jiangyin 214400,Jiangsu Province,China)

机构地区：[1]江阴市人民医院妇产科,江苏江阴214400

出　　处：《中外医药研究》2024年第30期30-32,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:对比腹腔镜子宫动脉阻断联合子宫腺肌瘤病灶切除术后应用米非司酮与左炔诺孕酮宫内缓释系统的效果。方法:选择2019年1月—2023年12月在江阴市人民医院接受腹腔镜子宫动脉阻断联合子宫腺肌瘤病灶切除术治疗的70例子宫腺肌瘤患者为研究对象,根据随机数字表法将患者纳入米非司酮组和曼月乐组,各35例。米非司酮组术后口服米非司酮片,曼月乐组术后宫内放置左炔诺孕酮宫内缓释系统。对比两组疗效、激素水平、月经情况和不良反应发生情况。结果:曼月乐组治疗总有效率高于米非司酮组(P=0.040);治疗3个月后,两组雌二醇、黄体生成素和促卵泡成熟激素水平下降,曼月乐组低于米非司酮组(P<0.05);治疗3个月后,两组月经期缩短、月经周期延长、月经期视觉模拟评分法评分降低,且曼月乐组月经期视觉模拟评分法评分低于米非司酮组(P<0.05);两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:在腹腔镜子宫动脉阻断联合子宫腺肌瘤病灶切除术后应用左炔诺孕酮宫内缓释系统的效果较好,能调节激素水平,改善月经情况,且未增加不良反应发生风险。Objective:To compare the efficacy of the application of mifepristone versus levonorgestrel intrauterine extendedrelease system after laparoscopic uterine artery blockade combined with resection of uterine adenomyoma lesions.Methods:Seventy patients with adenomyomas who underwent laparoscopic uterine artery blockade combined with uterine adenomyoma lesion resection in Jiangyin People's Hospital from January 2019 to December 2023 were selected as the study subjects,and the patients were included in the mifepristone group and the mirena group of thirty-five cases each according to the method of randomized numerical table.Mifepristone tablets were taken orally after surgery in the mifepristone group,and levonorgestrel intrauterine extended-release system was placed intrauterine after surgery in the mirena group.The efficacy,hormone level,menstrual situation and the occurrence of adverse reactions were compared between the two groups.Results:The total effective rate of treatment was higher in the mirena group than in the mifepristone group(P=0.040);after 3 months of treatment,the levels of estradiol,luteinizing hormone and follicle maturation stimulating hormone declined in the two groups,and the mirena group was lower than that of the mifepristone group(P<0.05);after 3 months of treatment,the menstrual period was shortened,the menstrual cycle was prolonged,and the score of visual analog scoring method of menstrual period was decreased in both groups,and the score of visual analog scoring method of menstrual period was lower in the mirena group than that of the mifepristone group(P<0.05);comparing the total incidence rate of adverse reactions in the two groups,the difference was not statistically significant(P>0.05).Conclusion:The application of levonorgestrel intrauterine extended-release system after laparoscopic uterine artery blockade combined with resection of uterine adenomyoma lesions was more effective in regulating hormone levels,improving menstruation,and did not increase the risk of adverse reactions.

关 键 词：子宫腺肌瘤 子宫动脉阻断 子宫腺肌瘤病灶切除术 米非司酮 左炔诺孕酮宫内缓释系统 

分 类 号：R737.33[医药卫生—肿瘤]