醋酸戈舍瑞林缓释植入剂治疗术后复发卵巢内膜囊肿的临床观察

发布时间：2018-03-04 10:03

本文选题：卵巢内膜囊肿　切入点：醋酸戈舍瑞林缓释植入剂　出处：《中国药房》2017年14期 　论文类型：期刊论文

【摘要】：目的:探讨醋酸戈舍瑞林缓释植入剂(AGRI)治疗腹腔镜卵巢囊肿摘除术后复发卵巢内膜囊肿(OEC)的疗效及安全性。方法:选取张家港市第一人民医院2013年1月-2015年1月行腹腔镜卵巢囊肿摘除术后复发的OEC患者60例,采用随机数字表法分为对照组和观察组,各30例。两组患者均口服米非司酮片25 mg,qd。对照组患者口服孕三烯酮胶囊2.5 mg,2次/周;观察组患者给予AGRI 3.6 mg,皮下注射,1次/月,两组患者均持续治疗6个月。观察两组患者临床疗效,治疗前及治疗3、6个月血清促卵泡激素(FSH)、黄体生成素(LH)、雌二醇(E_2)水平和痛经、慢性盆腔痛视觉模拟评分法(VAS)评分,观察两组患者不良反应发生情况及随访12个月的预后情况。结果:观察组患者临床总有效率为86.67%,显著高于对照组的70.00%,差异有统计学意义(P0.05)。治疗3个月,两组患者FSH、LH水平较治疗前显著降低,差异有统计学意义(P0.05),但E_2水平无变化,且FSH、LH组间比较,差异均无统计学意义(P0.05);治疗6个月,两组患者FSH、LH、E_2水平均显著降低,且观察组显著低于对照组,差异均有统计学意义(P0.05)。治疗3、6个月,两组患者痛经、慢性盆腔痛VAS评分均显著降低,且观察组显著低于对照组,差异均有统计学意义(P0.05)。观察组患者不良反应发生率40.00%,显著高于对照组的16.70%,差异有统计学意义(P0.05)。两组患者复发率比较,差异无统计学意义(P0.05),但观察组患者月经恢复正常率为86.67%、优势卵泡形成率为60.00%、妊娠率为53.33%,显著高于对照组的46.67%、46.67%、33.33%,差异均有统计学意义(P0.05)。结论:AGRI治疗腹腔镜卵巢囊肿摘除术后复发OEC疗效显著,可有效缓解患者痛经和慢性盆腔痛,提高妊娠率;停药后仍有复发病例,且不良反应发生率较高,但症状轻微。
[Abstract]:Objective: to investigate the efficacy and safety of Gosherrelin Acetate sustained release implantation (AGRI) in the treatment of recurrent ovarian endometrial cysts after laparoscopic ovarian cyst excision. Methods: the first people's Hospital of Zhangjiagang City from January 2013 to January 2015 was selected. There were 60 cases of recurrent OEC after laparoscopic ovarian cyst extirpation. The patients in the control group were divided into the control group and the observation group with 30 cases each. The patients in both groups were given mifepristone tablets 25 mg / d, the control group were given 2. 5 mg of pregnenone capsules twice a week, and the patients in the observation group were given AGRI 3. 6 mg subcutaneously once a month, and the patients in the control group were given subcutaneous injection of mifepristone tablets once a month. The clinical efficacy, serum follicle stimulating hormone (FSH), luteinizing hormone (LHN), estradiol (E _ 2) and VAS-score of dysmenorrhea and chronic pelvic pain were observed in both groups for 6 months. Results: the total effective rate of the patients in the observation group was 86.67, significantly higher than that in the control group (70.005%), and the difference was statistically significant (P 0.05). The level of FSHO LH in the two groups was significantly lower than that before treatment, the difference was statistically significant (P 0.05), but there was no change in the E2 level, and there was no significant difference in the level of FSH LH between the two groups, and after 6 months of treatment, the level of FSH LHN E2 in the two groups was significantly lower than that in the control group, and there was no significant difference in the level of E 2 between the two groups after 6 months of treatment. The VAS scores of dysmenorrhea and chronic pelvic pain in the observation group were significantly lower than those in the control group, and were significantly lower in the observation group than in the control group. The incidence of adverse reactions in the observation group was significantly higher than that in the control group (P 0.05), and the incidence of adverse reactions in the observation group was significantly higher than that in the control group (P 0.05), and the recurrence rate of the two groups was higher than that of the control group (P 0.05). The difference was not statistically significant (P 0.05), but the menstrual recovery rate, dominant follicle formation rate and pregnancy rate in the observation group were 86.67, 60.00and 53.33, respectively, which were significantly higher than those in the control group (46.67g / 46.67g / 33.33g). Except for the postoperative recurrence of OEC, the curative effect was significant. It can effectively relieve dysmenorrhea and chronic pelvic pain and increase pregnancy rate.
【作者单位】：张家港市第一人民医院妇科;张家港市中医院妇科;
【分类号】：R713.6

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