左炔诺孕酮宫内缓释系统预防子宫内膜异位症术后复发的疗效

发布时间：2018-04-14 21:55

本文选题：左炔诺孕酮宫内缓释系统 + 子宫内膜异位症　；参考：《中国医科大学学报》2017年09期

【摘要】：目的探讨左炔诺孕酮宫内缓释系统(LNG-IUS)预防子宫内膜异位症术后复发的安全性及有效性。方法收集2013年1月至2014年12月于中国医科大学附属盛京医院妇产科因中、重度子宫内膜异位症行保守手术治疗的患者。术后按患者治疗意愿将其分为3组:A组,术后单纯应用促性腺激素释放激素激动剂(Gn RH-a)3个周期;B组,术后单纯应用LNG-IUS;C组,术后立即应用Gn RH-a 3个周期,注射第3针当日宫内放置LNG-IUS。所有患者于术后3、6、12、24个月随访,评价痛经缓解程度,同时复查盆腔彩超及血清CA125,明确复发情况。记录所有患者治疗相关不良反应。结果共纳入患者83例,其中A组21例,B组29例,C组33例。术后3个月时,3组患者VAS评分均较术前明显降低(P0.05)。术后6个月及12个月时,3组VAS评分无统计学差异(P0.05),术后24个月时,A组VAS评分明显高于其他2组(P0.05)。至术后24个月,共8例患者子宫内膜异位症复发,其中A组4例(19.05%),B组3例(10.71%),C组1例(3.13%),3组间复发率有统计学差异(P0.05)。所有患者随访过程中均未发生严重不良反应。结论子宫内膜异位症术后应用LNG-IUS,能有效预防囊肿复发并缓解疼痛,与Gn RH-a联合应用能够进一步提高疗效。
[Abstract]:Objective to investigate the safety and efficacy of levonorgestrel intrauterine sustained release system (LNG-IUS) in the prevention of postoperative recurrence of endometriosis.Methods from January 2013 to December 2014 patients with moderate or severe endometriosis underwent conservative surgical treatment in Shengjing Hospital affiliated to China Medical University.The patients were divided into 3 groups according to their intention to treat. Group B was treated with gonadotropin releasing hormone agonist (Gn RH-a) for 3 cycles, group B was treated with LNG-IUSC only, and group G _ n RH-a was given immediately after operation.LNG-IUSs were placed intrauterine on the day of the third injection.All the patients were followed up for 12 months and 24 months after operation to evaluate the degree of dysmenorrhea relief, and to review the pelvic color Doppler ultrasound and serum CA125 to determine the recurrence of dysmenorrhea.All patients with treatment-related adverse reactions were recorded.Results A total of 83 cases were included, including 21 cases in group A, 29 cases in group B and 33 cases in group C.At 3 months after operation, the VAS scores in the three groups were significantly lower than those before operation.At 6 and 12 months after operation, there was no significant difference in VAS scores among the three groups. The VAS scores in group A were significantly higher than those in the other two groups at 24 months after operation (P 0.05).Up to 24 months after operation, 8 cases of endometriosis recurred, of which 4 cases in group A were diagnosed as normal, 3 cases in group B and 3 cases in group C, with a significant difference in recurrence rate between group C and group C (P 0.05).No serious adverse reactions occurred during follow-up in all patients.Conclusion LNG-IUSis can effectively prevent the recurrence of cysts and relieve pain after operation of endometriosis. The combination of LNG-IUSwith Gn RH-a can further improve the curative effect.
【作者单位】：中国医科大学附属盛京医院妇产科;武警辽宁省总队医院特检科;
【分类号】：R713

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