激素替代治疗子宫内膜异位症根治术后42例疗效观察

The effects and safety of hormone replacement therapy on women with endometriosis and underwent hysterectomy and bilateral salpingo-ophorectomy

目的：探讨应用激素替代治疗改善子宫内膜异位症根治术后围绝经期症状的疗效和安全性。方法：2002年1月～2004年12月因重度子宫内膜异位症行根治术出现围绝经期症状的患者42例，随机分成2组。观察组22例口服倍美力0．3mg，1次／d，对照组20例口服利维爱1．25mg，1次／d。治疗前后检测血清FSH（卵泡刺激素）和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，Kupperman（K评分）1次／月。结果：两组治疗后围绝经期症状均明显改善，血清E2水平上升，治疗前后比较差异有显著性意义（P〈0．01），无内膜异位症复发表现。治疗后的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重度子宫内膜异位症根治术后患者，能有效地控制围绝经期症状，安全，无复发。

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 - ophorectomy （BSO） and had the symptoms of perimenopause. Methods： 42 patients were divided into two groups randomly. 20 received livial 1.25 mg every day orally, and 22 received Premarin 0.3 mg everyday orally. Periodical clinical examination and vaginal ultrasound were performed, and the level of E2/FSH and the symptoms of endometriosis 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 perimenopause 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 premarin had higher level of E2 than the group who received livial （P 〈 0.05）. Conclusion： The low dose premarin and livial can relieve climacteric symptoms safely on women who have had endometriosis and underwent hysterectomy and bilateral salpingo - ophorectomy.