手术联合药物治疗子宫内膜异位症痛经的疗效观察

The clinical effect observation of operation combined with drugs in the treatment of endometriosis dysmenorrhea

目的:探讨保守性手术联合药物治疗子宫内膜异位症痛经的临床疗效。方法:选择76例子宫内膜异位症典型痛经患者,拒绝手术要求口服药物治疗的38例患者为对照组,保守性手术治疗术后辅以药物治疗的38例为治疗组。治疗后随访2年,观察患者痛经的治疗效果及药物不良反应。结果:治疗组治疗痛经的有效率为86.84%,高于对照组的47.30%(P<0.05)。服用孕三烯酮、米非司酮、去氧孕烯炔雌醇患者的胃肠道反应、阴道异常出血、体质量增加平均发生率分别为18.42%、22.37%、18.40%,差异均无统计学意义(P>0.05)。结论:痛经是子宫内膜异位症最常见症状,保守性手术后配合药物治疗可作为首选治疗,术后个体化用药可参考不良反应决定。

Objective：To investigate the clinical effects of the conservative operation combined with drugs in the treatment of endometriosis dysmenorrhea.Methods：Seventy-six patients with endometriosis dysmenorrhea were divide into control group（38 cases） who refused surgery and requested oral drugs and treatment group（38 cases） who were treated with conservative operation combined with drugs.The symptoms of dysmenorrhea,relapse and adverse reactions of all patients were followed up for 2 years after therapy.Results：The effective rate of the treatmet group（86.84%） was higher than that of control group（47.30%）（P0.01）.The average incidence of gastrointestinal reaction,abnormal vaginal bleeding and weight gain of patients taking gestrinone,mifepristone and desogestrel ethinylestradiol were 18.42%,22.37% and 18.40%,respectively,which differences were not statistic significance（P0.05）.Conclusions：Dysmenorrheal is one of the most common symptoms for endometriosis.The treatment of conservative operation combined with drugs can serve as the first choice.The postoperative drug selection may be based on individual adverse reactions.