术后药物辅助治疗子宫内膜异位症疗效观察

目的 观察子宫内膜异位症患者剖腹探查术或腹腔镜术后辅助孕三烯酮、醋酸亮丙瑞林微球及醋酸亮丙瑞林微球治疗3个月后安置左炔诺孕酮宫内节育系统的临床效果、不良反应及停药后复发率.方法 选择2010年3月至2013年6月在中航工业363医院确诊为子宫内膜异位症患者80例为研究对象,将其根据患者的意愿分为孕三烯酮组（n=28）、醋酸亮丙瑞林微球组（n=32）及醋酸亮丙瑞林微球＋左炔诺孕酮宫内节育系统组（n=20）,对比分析各组的治疗有效率、不良反应和复发率（本研究遵循的程序符合中航工业363医院人体试验委员会制定的伦理学标准,得到该委员会批准,分组征得受试对象知情同意,并与之签署临床研究知情同意书）.结果 各组的治疗总有效率、复发率相近,差异无统计学意义（P〉0.05）;不良反应比较,3组均出现不同程度体质量增加,但3组间比较,差异无统计学意义（P〉0.05）,孕三烯酮组转氨酶升高明显,醋酸亮丙瑞林微球组潮热发生率高,与其余2组比较,差异均有统计学意义（P〈0.01）.结论 子宫内膜异位症术后加用孕三烯酮治疗、醋酸亮丙瑞林微球治疗及醋酸亮丙瑞林微球治疗3个月后安置左炔诺孕酮宫内节育系统治疗效果是相似的;醋酸亮丙瑞林微球治疗3个月后安置左炔诺孕酮宫内节育系统对肝功能影响小,可减少潮热的发生,可以长期治疗子宫内膜异位症,减少复发.

Effect of Medical Assistance in the Treatment of Endometriosis After Surgery

Objective To observe the curative effect, untoward effect and relapse rate after drug withdrawal in the patients with endometriosis who accepted the medical assistance of gestrinone,leuprorelin acetate microspheres,and placement of left acetylene progesterone intrauterine birth control system after three months＇ leuprorelin acetate microspheres therapy with laparotomy or laparoscopic surgery. Methods A total of 80 cases with endometriosis from March 2010 to June 2013 in Avic 363 hospital that went under the surgery were divided into （according to the patient＇s wishes）gestrinone group（n=28）, leuprorelin acetate microspheres group（n=32） and leuprorelin acetate microspheres with left acetylene progesterone intrauterine birth control system group（n=20）. The curative effect, untoward effect and relapse rate were compared among 3 groups.The study protocol was approved by the Ethical Review Board of Investigation in Human Beings of Avic 363 Hospital.Informed consent was obtained from each participating patient. Results There had no significant differences among 3 groups in the curative effect and relapse rate（P〉0.05） meanwhile also had no significant differences in the untoward effect which performed as weight gain（P〉0.05）. Transaminase lifted higher in gestrinone group and fever occurred more in leuprorelin acetate microspheres group than that in other 2 groups and had significant differences（P〈0.01）. Conclusions Endometriosis after surgery and treated with gestrinone, leuprorelin acetate microspheres and leuprorelin acetate microspheres 3 months then with left acetylene progesterone intrauterine birth control system have similar curative effect. Placement of left acetylene progesterone intrauterine birth control system after three months＇ treatment with leuprorelin acetate microspherehas has small effect on liver function and can reduce hot flashes and can be a long-term treatment for endometriosis and reduce the recurrence