Ⅳ期子宫内膜异位症患者术后不同药物治疗效果观察  

Clinical efficacy of different postoperative drug treatments for patients with stageⅣendometriosis

作　　者：刘湛秋 王玲玲 胡晓文 Liu Zhanqiu;Wang Lingling;Hu Xiaowen(Department of Obstetrics and Gynecology,The First Affiliated Hospital of Bengbu Medical University,Bengbu233030,Anhui Province,China)

机构地区：[1]蚌埠医科大学第一附属医院妇产科,蚌埠233030

出　　处：《中国基层医药》2024年第12期1835-1839,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：安徽省教育厅高校自然科学研究重点项目(KJ2021A0754);蚌埠医科大学科技项目自然科学重点项目(2023byzd057)。

摘　　要：目的探讨Ⅳ期子宫内膜异位症(EMT)患者术后不同药物治疗的临床疗效。方法回顾性分析2020年1月至2023年6月在蚌埠医科大学第一附属医院妇科住院并行保留生育功能手术、术后病理证实为EMT的近期有生育需求患者100例的临床资料, 根据术后辅助不同药物治疗将其分为两组, 亮丙瑞林组和地诺孕素组各50例, 比较两组患者治疗效果, 观察两组治疗前后性激素水平变化、痛经程度变化、术后1年妊娠率及不良反应发生情况。结果治疗后两组血清雌二醇、黄体生成素、卵泡刺激素分别为(35.77±6.28)ng/L、(0.50±0.03)IU/L、(3.90±0.32)IU/L、(23.36±6.09)ng/L、(0.30±0.02)IU/L、(2.68±0.28)IU/L均低于治疗前, 差异均有统计学意义(t=40.15、112.95、36.25、27.87、124.87、75.86, 均P < 0.05)。地诺孕素组术后疼痛视觉模拟评分低于亮丙瑞林组(t=-11.50, P < 0.05), 且术后1年妊娠率明显高于亮丙瑞林组(χ^(2)=3.90, P < 0.05)。结论在提高生育能力和减轻痛经严重程度方面, 与手术后联合亮丙瑞林干预相比, 使用地诺孕素作为Ⅳ期EMT患者术后药物治疗显示出更高的有效性。ObjectiveTo investigate the clinical efficacy of different postoperative drug treatments for patients with stageⅣendometriosis.MethodsA retrospective analysis was conducted on 100 patients with a recent need for fertility who underwent fertility-preserving surgery and were pathologically confirmed to have endometriosis after surgery at the Department of Gynecology of The First Affiliated Hospital of Bengbu Medical University between January 2020 and June 2023.Based on the different adjuvant drugs used for postoperative treatment,the patients were divided into two groups:the leuprolide group and the dienogest group,with 50 patients in each group.The therapeutic effects of the two groups were compared,including changes in sex hormone levels and severity of dysmenorrhea after treatment compared with before treatment.Additionally,pregnancy rate 1 year after surgery and the occurrence of adverse reactions were also monitored.ResultsAfter treatment,the serum levels of estradiol,luteinizing hormone,and follicle-stimulating hormone in the dienogest group were(35.77±6.28)ng/L,(0.50±0.03)IU/L,and(3.90±0.32)IU/L,respectively,and they were(23.36±6.09)ng/L,(0.30±0.02)IU/L,and(2.68±0.28)IU/L,respectively in the leuprolide group.All these measurements were significantly lower than those recorded before treatment in the corresponding group(t=40.15,112.95,36.25,27.87,124.87,75.86,all P<0.05).After surgery,the Visual Analog Scale score in the dienogest group was significantly lower than that in the leuprolide group(t=-11.50,P<0.05).Within 1 year after surgery,the pregnancy rate in the dienogest group was significantly higher than that in the leuprolide group(χ^(2)=3.90,P<0.05).ConclusionCompared with postoperative intervention using leuprolide,dienogest as a postoperative drug therapy for patients with stage IV endometriosis demonstrated greater effectiveness in improving fertility and reducing the severity of dysmenorrhea.

关 键 词：子宫内膜异位症 雌二醇 促黄体激素 卵泡刺激素 痛经 生育力 疗效比较研究 

分 类 号：R713.4[医药卫生—妇产科学]