子宫内膜异位症术后辅助甲羟孕酮治疗临床观察

Use of medroxyprogesterone after conservative surgery for endometriosis

目的 :观察子宫内膜异位症术后辅助应用甲羟孕酮治疗的疗效及副反应。方法 :将 1 997年 1月～ 2 0 0 0年 6月我院行非根治性手术的子宫内膜异位症患者 1 0 2例 ,分为治疗组 4 7例 ,术后给予甲羟孕酮 1 0 0mg ,2次 /天 ,连续应用 6个月。对照组 5 5例 ,行相同的手术治疗术后不给辅助治疗。观察两组术后 6个月的症状、体征缓解率及术后 2 4个月两组的复发率。结果 :术后 6个月两组的症状缓解率分别为 1 0 0 %、81 .8% (P <0 .0 1 ) ;体征的缓解率分别为 97.8%、81 .8% (P <0 .0 1 )。术后2 4个月两组的复发率分别为 8.5 %、2 3.6 % (P <0 .0 5 )。治疗组 3例分别于术后 2个月、3个月出现轻度肝功能异常 ,经保肝治疗后恢复。 1 1例有恶心、纳差 ,经对症处理后缓解。结论 :子宫内膜异位症术后辅助应用甲羟孕酮对降低其术后的复发有一定疗效 。

Objective:To study the efficacy of medroxyprogesterone in endometriosis after conservative surgery.Methods:From 1997 to 2000,102 women with endometriosis received conservative surgery in our hospital.They were divided into two groups.Group A( n =47) were treated with medroxyprogesterone(200 mg/d.Po) for six months.Group B( n =55) were for control.Relief and recurrent rates were analyzed six months and two years after surgery respectively.Results:The six month symptom relief rates of the two groups were 100% and 81.8%,respectively( P <0.01).The sign relief rates of the two groups were 97.8% and 81.8%,respectively( P <0.01).The two year recurrent rates of the two groups were 8.5% and 23.6%,respectively( P <0.05).The level of alanine aminotransferase(ALT) increased in 2 of the 47 cases.Eleven of the 47 cases had nausea or vomiting.Conclusions:Using medroxyprogesterone after consevative surgery for endometriosis can reduce the recurrent rates.