摘要
目的:探讨宫内节育系统曼月乐联合促性腺激素释放激素激动剂(GnRH-a)对子宫腺肌症(AM)患者子宫体积、血清人附睾蛋白4(HE4)水平及月经失血图(PBAC)评分的影响。方法:选取2020年1月-2022年1月本院收治的AM患者96例,随机数字表法分为3组,术后曼月乐组(n=32)放置曼月乐治疗,GnRH-a组(n=32)给予单纯GnRH-a治疗,联合组(n=32)放置曼月乐联合GnRH-a治疗。对比3组痛经程度[视觉模拟评分(VAS)]、子宫体积、血清HE4水平、PBAC评分及复发情况。结果:治疗后6、12个月,联合组VAS评分(1.86±0.58分、1.45±0.47分)均低于GnRH-a组(3.42±1.07分、2.89±0.88)和曼月乐组(7.14±1.27分、2.03±0.59分),子宫体积(88.32±29.23 cm^(3)、89.35±27.49 cm^(3))小于GnRH-a组(105.32±32.34 cm^(3)、104.78±32.57 cm^(3))和曼月乐组(108.27±33.25 cm^(3)、104.78±32.57 cm^(3)),血清HE4水平(43.86±3.85 U/ml、42.22±3.36 U/ml)、PBAC评分(78.62±19.63分、63.74±18.18分)均低于GnRH-a组(50.28±4.27 U/ml、48.43±4.14 U/ml,95.75±24.34分、90.89±29.94分)和曼月乐组(49.44±4.46 U/ml、47.86±4.32 U/ml,90.87±22.76分、88.65±28.92分),治疗后12个月复发率联合组(0、0)低于GnRH-a组(6.3%)和曼月乐组(3.1%、18.8%)(均P<0.05)。结论:曼月乐联合GnRH-a治疗AM,能明显减轻患者术后痛经程度,缩小子宫体积,降低血清HE4水平,减小PBAC评分,减少术后复发。
Objective:To investigate the effects of Mirena combined with gonadotropin-releasing hormone agonist(GnRH-a)for treating patients with adenomyosis(AM)after operation on their uterine volume,serum human epididymis protein 4(HE4)level,and pictorial blood loss assessment chart(PBAC)score.Methods:96 patients with AM after operation were selected and were divided into three groups(32 cases in each group)according to the random number table method from January 2019 to August 2020.The patients in group A were given Mirena inserted after operation,the patients in group B were given GnRH-a treatment after operation,and the patients in group C were given Mirena inserted combined with GnRH-a treatment after operation.The degree of dysmenorrhea evaluated by visual analogue scale(VAS),the uterine volume,the serum HE4 level,the PBAC score,and the recurrence of AM of the patients were compared among the three groups.Results:At 6 and 12 months after treatment,the VAS scores(1.86±0.58 points and 1.45±0.47 points)of the patients in group C were significantly lower than those(3.42±1.07 points and 2.89±0.88 points)of the patients in group B,and those(7.14±1.27 points and 2.03±0.59 points)of the patients in group A.The values of the uterine volume(88.32±29.23cm^(3)and 89.35±27.49cm^(3))of the patients in group C were significantly lower than those(105.32±32.34cm^(3)and 104.78±32.57cm^(3))of the patients in group B,and those(108.27±33.25cm^(3)and 104.78±32.57cm^(3))of the patients in group A.The serum HE4 levels(43.86±3.85 U/ml and 42.22±3.36U/ml)of the patients in group C were significantly lower than those(50.28±4.27U/ml and 48.43±4.14U/ml)of the patients in group B,and those(49.44±4.46U/ml and 47.86±4.32U/ml)of the patients in group A.The PBAC score(78.62±19.63points and 63.74±18.18points)of the patients in group C were significantly lower than those(95.75±24.34points and 90.89±29.94points)of the patients in group B,and those(90.87±22.76points and 88.65±28.92points)of the patients in group A.The recurrence ra
作者
楚贺敏
贺全勤
杨蕾
CHU Hemin;HE Quanqin;YANG Lei(Zhumadian Hospital of Traditional Chinese Medicine,Henan Province,463000;Zhumadian Central Hospital,Henan Province;The First Affiliated Hospital of Zhengzhou University)
出处
《中国计划生育学杂志》
2023年第1期32-36,共5页
Chinese Journal of Family Planning
基金
河南省医学科技攻关计划(联合共建)项目(LHGJ20190129)。
关键词
子宫腺肌症
曼月乐
促性腺激素释放激素激动剂
子宫体积
人附睾蛋白4
痛经月经失血图
复发
Adenomyosis
Mirena
Gonadotropin-releasing hormone agonist
Uterine volume
Human epididymis protein 4
Dysmenorrhea
Pictorial blood loss assessment chart
Recurrence
