摘要
目的探讨GnRHa联合不同药物治疗在子宫内膜异位症术后长期管理中的应用效果,并分析疾病复发的影响因素。方法选取2019年4月—2021年4月永康市妇幼保健院收治的实施腹腔镜手术的90例子宫内膜异位症患者为研究对象,根据使用药物不同将所有患者分为A组、B组及C组,每组各30例,其中A组患者接受促性腺激素释放激素激动剂(GnRHa)联合曼月乐环治疗,B组患者接受GnRHa联合散结镇痛胶囊治疗,C组患者接受GnRHa联合地诺孕素治疗。比较3组患者的治疗效果、中医症状评分、疼痛情况、类绝经症状、血清学指标及不良反应发生率;跟踪随访3组患者复发情况,并对相关影响因素进行logistic回归分析。结果A组和C组患者治疗总有效率、中医症状评分、血清学指标、复发率及不良反应发生率比较,差异均无统计学意义(均P>0.05)。A组和C组的治疗总有效率(90.00%、93.33%)均高于B组(66.67%),差异均有统计学意义(χ^(2)=4.812、6.667,均P<0.05)。A组和C组患者的黄体生成激素(LH)水平[(10.45±1.62)U/L、(11.01±1.11)U/L]均高于B组[(8.49±1.03)U/L],差异均有统计学意义(t=5.592、9.115,均P<0.05)。A组和C组患者的疾病复发率(16.67%、20.00%)均低于B组(43.33%),差异均有统计学意义(χ^(2)=5.078、6.648,均P<0.05)。A组患者的中医症状评分[(4.20±1.36)分]、卵泡刺激素(FSH)水平[(7.11±1.92)U/L]、雌二醇(E2)水平[(206.33±12.36)pmol/L]及抗苗勒管激素(AMH)水平[(2.10±0.52)ng/ml]均低于B组[(5.44±1.01)分、(8.32±1.01)U/L、(233.36±15.22)pmol/L、(2.88±0.36)ng/ml],差异均有统计学意义(t=3.140、3.055、7.551及6.775,均P<0.05);C组患者的中医症状评分[(4.36±0.88)分]、FSH水平[(6.82±1.03)U/L]、E2水平[(205.88±13.01)pmol/L]、AMH水平[2.03±0.55)ng/ml]均低于B组,差异均有统计学意义(t=4.416、5.695、7.517及7.083均P<0.05)。C组患者的Kupperman评分(K评分)[(14.20±1.35)分]低于A组[(15.44±1.69)分]和B组[(1
Objective To investigate the effect of GnRHa combined with different drugs in the long-term management of endometriosis after surgery,and to analyze the influencing factors of disease recurrence.Methods A total of 90 patients with endometriosis who underwent laparoscopic surgery in Yongkang Maternal and Child Health Hospital from April 2019 to April 2021 were selected as the research ob⁃jects.According to the different drugs used,all patients were divided into group A,group B and group C,with 30 cases in each group.The patients in group A were treated with gonadotropin-releasing hormone agonist(GnRHa)combined with mirena,the patients in group B were treated with GnRHa combined with Sanjie analgesic capsule,and the patients in group C were treated with GnRHa combined with dien⁃ogest.The treatment effect,TCM symptom score,pain,menopausal symptoms,serological indicators and incidence of adverse reactions were compared among the three groups.The recurrence of the three groups was followed up,and the related influencing factors were analyzed by lo⁃gistic regression analysis.Results There were no significant differences in the total effective rate,TCM symptom score,serological indica⁃tors,recurrence rate and incidence of adverse reactions between group A and group C(all P>0.05).The total effective rates of group A and group C(90.00%,93.33%)were higher than those of group B(66.67%),the differences were statistically significant(χ^(2)=4.812,6.667,all P<0.05).The levels of luteinizing hormone(LH)in group A and group C[(10.45±1.62)U/L,(11.01±1.11)U/L]were high⁃er than those in group B[(8.49±1.03)U/L],the differences were statistically significant(t=5.592,9.115,all P<0.05).The dis⁃ease recurrence rate of group A and group C(16.67%,20.00%)was lower than that of group B(43.33%),and the differences were sta⁃tistically significant(χ^(2)=5.078,6.648,all P<0.05).The TCM symptom score of patients in group A was(4.20±1.36)points,the level of follicle stimulating hormone(FSH)was(7.11±1.92)U/L,the level of estrad
作者
施灵美
邹雪平
左海红
SHI Ling-mei;ZOU Xue-ping;ZUO Hai-hong(Department of Gynecology,Yongkang Maternal and Child Health Hospital,Yongkang,Zhejiang 321300,China)
出处
《中国妇幼保健》
CAS
2023年第10期1838-1843,共6页
Maternal and Child Health Care of China
基金
浙江省永康市科技计划项目(202120)。
关键词
子宫内膜异位症
腹腔镜手术
影响因素
复发率
Endometriosis
Laparoscopic surgery
Influencing factors
Recurrence rate
