地诺孕素在子宫腺肌病患者高强度超声聚焦治疗后的应用效果及安全性  

Comparison of the effects and safety of dienogest after high-intensity focused ultrasound therapy in patients with uterine adenomyosis

作　　者：何浏铭 黄剑 黄菲 HE Liu-ming;HUANG Jian;HUANG Fei(Department of Gynecology,Qinzhou Maternal and Child Health Hospital,Qinzhou Guangxi 535000,China)

机构地区：[1]钦州市妇幼保健院妇科,广西钦州535000

出　　处：《临床和实验医学杂志》2024年第24期2636-2640,共5页Journal of Clinical and Experimental Medicine

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(编号:Z-D20221726)。

摘　　要：目的比较地诺孕素在子宫腺肌病患者高强度超声聚焦(HIFU)治疗后的应用效果及安全性。方法前瞻性选取2021年8月至2022年10月就诊于钦州市妇幼保健院的102例子宫腺肌病患者作为研究对象。采用简单随机法将患者分为对照组和观察组,每组各51例。两组均给予HIFU治疗,观察组术后另给予地诺孕素治疗,口服,2 mg/次,1次/d,连续治疗3个月经周期。比较两组术前、术后3个月、术后1年的病灶体积,并计算两组术后3个月、术后1年的子宫体积缩小率,比较两组术前、术后3个月、术后1年的糖类抗原125(CA125)、血红蛋白、前列腺素2α(PG2α)、性激素(雌二醇、黄体生成素)、视觉模拟评分法(VAS)评分、月经量评分变化,并记录两组不良反应发生情况。结果术后3个月、术后1年,两组病灶体积均较术前降低,差异均有统计学意义(P<0.05);观察组术后3个月、术后1年病灶体积分别为(18.32±2.98)、(14.34±2.34)cm 3,均低于对照组[(19.89±3.12)、(16.17±2.82)cm 3],子宫体积缩小率分别为(27.84±6.01)%、(39.04±5.11)%,均高于对照组[(23.26±5.78)%、(34.56±6.59)%],差异均有统计学意义(P<0.05)。术后3个月、术后1年,两组CA125、PGF2α水平均较术前降低,血红蛋白水平均较前升高,差异均有统计学意义(P<0.05);观察组术后3个月的CA125、PGF2α水平分别为(48.96±18.97)U/mL、(391.65±51.45)pg/mL,术后1年的CA125、PGF2α水平分别为(36.25±8.47)U/mL、(231.02±34.71)pg/mL,均低于对照组[(61.01±22.36)U/mL、(465.51±57.43)pg/mL和(41.12±10.05)U/mL、(284.53±43.65)pg/mL],差异均有统计学意义(P<0.05),而血红蛋白水平与对照组比较,差异无统计学意义(P>0.05)。术后3个月、术后1年,两组雌二醇、黄体生成素水平均较术前降低,差异均有统计学意义(P<0.05);观察组术后3个月、术后1年的雌二醇、黄体生成素水平与对照组比较,差异均无统计学意义(P>0.05)。观察组累计不良反应发�Objective Comparison of the efficacy and safety of dienogest after high-intensity focused ultrasound(HIFU)therapy in patients with adenomyosis.Methods A total of 102 patients with adenomyosis who were treated in Qinzhou Maternal and Child Health Hospital from August 2021 to October 2022 were prospectively selected as the study subjects.The patients were divided into the control group and the observation group by simple random method,51 cases in each group.Both groups were given HIFU treatment,and the observation group was given postoperative dienogest treatment,oral,2 mg/times,1 times/d,continuous treatment of 3 menstrual cycles.The lesion volumes of the two groups before operation,3 months after operation and 1 year after operation were compared,and the uterine volume reduction rates of the two groups 3 months after operation and 1 year after operation were calculated.The changes of carbohydrate antigen 125(CA125),hemoglobin,prostaglandin 2α(PG2α),sex hormones(estradiol,luteinizing hormone),visual analogue scale(VAS)score and menstrual volume score were compared between the two groups before operation,3 months after operation and 1 year after operation,and the occurrence of adverse reactions in the two groups was recorded.Results At 3 months and 1 year after operation,the lesion volume of the two groups was lower than that before operation,and the differences were statistically significant(P<0.05).The lesion volumes of the observation group at 3 months and 1 year after operation were(18.32±2.98)and(14.34±2.34)cm 3,respectively,which were lower than those of the control group[(19.89±3.12)and(16.17±2.82)cm 3],and the uterine volume reduction rates were(27.84±6.01)% and(39.04±5.11)%,respectively,which were higher than those of the control group[(23.26±5.78)% and(34.56±6.59)%],the differences were statistically significant(P<0.05).At 3 months and 1 year after operation,the levels of CA125 and PGF2αin the two groups were lower than those before operation,and the hemoglobin level was higher than that before

关 键 词：子宫 地诺孕素 子宫腺肌病 高强度超声聚焦 疗效 安全性 

分 类 号：R73[医药卫生—肿瘤]