摘要
目的:观察手术联合地屈孕酮治疗卵巢子宫内膜异位症(简称内异症)的临床疗效和安全性。方法:选取76例卵巢子宫内膜异位症患者经开腹或腹腔镜术中诊断为Ⅰ型、Ⅱ型、Ⅲ型和Ⅳ型,伴有或不伴有不孕症,随机分为对照组和观察组,分别为76例、54例。对照组采用孕三烯酮组,第一次月经来潮第1天开始,2.5mg/次,每周2次,观察组地屈孕酮20mg/d(重型患者30mg/d),于月经周期第5~25天口服,共3~6个月。观察用药后盆腔痛、痛经、性交痛,血清CA125值水平及要求妊娠患者的排卵监测等情况。结果:对照组与观察组用药后盆腔痛、痛经和性交痛均有明显改善,差异有统计学意义(P<0.05)。对照组与观察组用药后血清CA125均有明显下降,差异有统计学意义(P<0.05)。术后要求妊娠的患者服用地屈孕酮期间行阴超检查观察组和对照组均可见生长良好的卵泡及子宫内膜,并有排卵。观察组用药期间有3例患者诉乳房胀痛,余未发现明显不良反应。结论:卵巢子宫内膜异位囊肿术后应用地屈孕酮巩固治疗疗效好,不良反应少,服药期间有较高的排卵率。
Objective To evaluate the efficacy and safety of postoperative dydrogesterone in the treatment of endometriosis. Method Seventy-six patients suffering from Ⅰ,Ⅱ,Ⅲ or Ⅳ endometriosis,with or without infertility,who had undergone laparoscopy,randomly divided into observation group and control group,76 cases in control group and 54 in observation group.control group were treated with gestrinone 2.5 mg/biw orally from day 1 of each cycle for 3~6 months,Observation group were treated with dydrogesterone 20 mg/day (or 30 mg/day in severe cases) orally from day 5 to day 25 of each cycle for 3~6 months.After drug treatment,oberserve pelvic pain,dysmenorrhea,dyspareunia ,menstrual period and the amount of abnormal,the level of serum CA125 and assess ovulation in the patients who want to pregnant. Results Pelvic pain,dysmenorrhea and dyspareunia improved significantly after treatment in two groups( P <0.05).Serum CA125 reduced significantly ( P <0.05) after the treatment in two groups,the reduction werenot significantly.Patients in observation group who required pregnancy postoperative during medical treatment had a well-grown follicle and endometrial,and ovulation.In the observation group, 3 patients complained of breast swelling and pain,and no obvious adverse reactions were found. Conclusion Dydrogesterone is an effective and safe post-laparoscopic treatment for endometriosis,with so few side effects and high ovulating rate during treatment .
作者
李雪梅
何春妮
LI Xue-mei;HE Chun-ni(Department of Obstetrics and Gynecology,The First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China;Departumt of obstetrics and Gynecology,No.900 Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army,Fuzhou 350025,China)
出处
《吉林医学》
CAS
2019年第10期2244-2246,共3页
Jilin Medical Journal
基金
福建省自然科学基金[项目编号:2018J05126]
关键词
子宫内膜异位
地屈孕酮
孕三烯酮
疗效
Endometriosis
Dydrogesterone
Gestrinone
Therapeutic effect
