左炔诺孕酮宫内节育系统放置前给予戈舍瑞林治疗子宫腺肌病合并重度痛经的临床观察

发布时间：2018-05-12 21:55

本文选题：左炔诺孕酮宫内节育系统 + 促性腺激素释放激素激动剂　；参考：《中国药房》2017年26期

【摘要】：目的:探讨在左炔诺孕酮宫内节育系统放置前给予戈舍瑞林治疗子宫腺肌病合并重度痛经的临床效果及安全性。方法:选取三亚市计划生育技术服务中心2014年1月-2016年1月收治的子宫腺肌病合并重度痛经患者140例,按抽签法随机分为对照组和观察组,各70例。两组患者均在月经开始的7 d内放置左炔诺孕酮宫内节育系统,其中观察组患者在放置前1周给予醋酸戈舍瑞林缓释植入剂10.8 mg腹前壁皮下注射。6个月后进行疗效评定。比较两组患者的痛经改善情况,治疗前后的子宫体积、COX痛经症状评分量表(CMSS)评分、月经量、血红蛋白(Hb)和糖类抗原125(CA125)含量,以及不良反应发生情况。结果:观察组患者的痛经改善率为95.71%,显著高于对照组的81.43%,差异有统计学意义(P0.05)。治疗前,两组患者的上述指标比较,差异均无统计学意义(P0.05);治疗后,两组患者的CMSS评分和月经量均较治疗前显著降低或减少,Hb含量均较治疗前显著升高,CA125含量均较治疗前显著降低,且观察组均显著优于对照组,差异均有统计学意义(P0.05);两组患者治疗前后子宫体积比较,差异无统计学意义(P0.05)。两组患者的不良反应发生率(10.00%vs.14.29%)比较,差异无统计学意义(P0.05)。结论:左炔诺孕酮宫内节育系统放置前给予戈舍瑞林治疗子宫腺肌病合并重度痛经,可有效缓解患者痛经症状,减少月经量,改善Hb和CA125水平,且未增加不良反应发生风险。
[Abstract]:Objective: to investigate the clinical effect and safety of treatment of adenomyosis with severe dysmenorrhea before intrauterine birth control with levonorgestrel. Methods: 140 cases of adenomyosis complicated with severe dysmenorrhea were selected from January 2014 to January 2016 in Sanya Family Planning Technical Service Center. According to the method of drawing lots, 140 cases were randomly divided into control group and observation group, 70 cases each. In both groups, levonorgestrel intrauterine birth control system was placed within 7 days of menstruation. The patients in the observation group were injected with Goserelin acetate 10.8 mg into anterior abdominal wall 1 week before menstruation, and the curative effect was evaluated 6 months later. The improvement of dysmenorrhea, the score of uterine volume and Cox dysmenorrhea symptom scale (CMSS), menstrual volume, hemoglobin HB) and carbohydrate antigen 125CA125) before and after treatment were compared between the two groups, as well as the occurrence of adverse reactions. Results: the improvement rate of dysmenorrhea in the observation group was 95.71, which was significantly higher than that in the control group (81.43). The difference was statistically significant (P 0.05). Before treatment, there was no significant difference in the above indexes between the two groups. The CMSS score and menstrual volume of the two groups were significantly decreased or decreased compared with those before treatment, and the content of CA125 in the observation group was significantly higher than that before treatment, and the observation group was significantly better than the control group. There was no significant difference in uterine volume between the two groups before and after treatment. There was no significant difference in the incidence of adverse reactions between the two groups (10.00 vs 14.29). Conclusion: the treatment of severe dysmenorrhea with levonorgestrel before placement of levonorgestrel intrauterine birth control system can effectively relieve dysmenorrhea symptoms, reduce menstrual volume, improve HB and CA125 levels, and do not increase the risk of adverse reactions.
【作者单位】：三亚市计划生育技术服务中心妇产科;海南省农垦三亚医院妇产科;
【分类号】：R711.51;R711.71

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