子宫内膜异位症切除术后激素替代治疗疗效分析

The effects and Safety of hormone replacement therapy on women with endometriosis and underwent hysterectomy and bilateral Salpingo-oophorectomy

目的探讨激素替代治疗Ⅲ-Ⅳ期子宫内膜异位症切除术后(全子宫及双侧附件切除术后)的临床疗效与安全性。方法2002年1月至2005年1月将40例患者,随机分成两组,(各20例):观察组口服倍美力0.3-0.625mg,每日1次。对照组口服利维爱1.25mg,每日或隔日1次。治疗前后检查盆腔情况,肝肾功能,体内血清FSH(卵泡刺激素)血清E2(雌二醇)水平,记录治疗期间盆腔痛,性交痛等子宫内膜异位症相关症状和乳房胀痛等不良反应,Kupperman评分(K评分)每月1次。结果两组用药后围绝经期症状均明显改善,无子宫内膜异位症复发表现,血浆E2水平上升,治疗前后比较差异有显著性意义(P<0.01)。治疗后E2水平观察组高于对照组,两组比较差异有显著性意义(P<0.01),但均在安全范围内。结论小剂量倍美力和利维爱用于Ⅲ-Ⅳ期子宫内膜异位症切除术后患者,均能安全,有效地控制围绝经期症状。

Objective To estimate the recurrence of endometriosis and clinical effects after administration of hormone replacement therapy （HRT）among women who have had endometriosis and underwent hysterectomy and bilateral salpingo-oophoreetomy（BSO）. Methods 40 patients were divided into two groupes randomly. 20 received livial 1.25mg every other day or every day orally, and 20 received Conjugated Estrogens 0.3-0.625mg every day orally. Periodical clinical examination,vaginal uhrasound,radiographic examination of breast were performed,and the level of E2.FSH and the symptoms of eadometriosis were recorded. Kupperman score were observed before and after treatment between two groups. Results After treatment,there was no recurrence in two groups. The symptoms of perimenopanse were significantly improved in both groups （P〈0.01）,and the level of E2 significantly increased in two groups （P〈0.01）. The group who received estradiol valerate had higher level of E2 than the group who received livial （P〈0.05）. Conclusions The low dose Conjugated Estrogens and livial can relieve climaeteric symptoms safely on women who have had endometriosis and underwent hysterectomy and bilateral salpingo-oophorectomy,