腹腔镜术后左炔诺孕酮宫内缓释系统治疗子宫内膜异位症

目的探讨腹腔镜术后采用左炔诺孕酮宫内缓释系统治疗子宫内膜异位症的疗效。方法选择2009年1-2012年1月妇产科收治的经腹腔镜确诊的子宫内膜异位患者72例,将其随机分为观察组与对照组,各36例。两组患者均接受腹腔镜下保守手术,对照组进行期待观察,观察组术后在子宫内放置左炔诺孕酮宫内缓释系统,评估两种治疗方法对子宫内膜异位症的疗效。结果观察组治疗术后6个月视觉模拟评分(VAS)(4.13±0.82)较对照组(6.51±1.47)有显著性下降(P<0.05),术后12个月VA(S3.72±0.96)较对照组(5.93±1.38)有极显著性下降(P<0.01)。观察组糖类抗原125(CA 125)治疗后(26.3±7.2)显著低于于对照组(36.7±9.6)(P<0.05),两组促卵泡激素(FSH)、促黄体生成素(LH)、雌二醇(E2)术后差异均无统计学意义(P>0.05)。观察组治疗后完全缓解27例,明显缓解6例,部分缓解2例,治疗无效1例;对照组完全缓解16例,明显缓解12例,部分缓解5例,治疗无效3例,观察组总缓解(97.22%)率显著优于对照组(91.66%)(P<0.05)。结论腹腔镜术后采用左炔诺孕酮宫内缓释系统治疗子宫内膜异位症可以有效改善子宫内膜异位症患者临床症状,并有助于减少复发。

Objective To investigate the clinical efficacy of the levonorgestrel-releasing intrauterine systen＇i after laparoscopic surgery in the treatment of endometriosis. Methods 72 cases of patients with endometriosis patients in department obstetrics and gynecology from January 2009 to January 2012 were randomly divided into observation group and control group. All patients received laparoscopic conservative surgery, the control group accepted only observation, levonorgestrel-releasing intrauterine system were placed in utero of the treatment group and evaluate the efficacy of two treatment methods for endometriosis.Results After 6 months VAS scores of the observation group （4.134-0.82）significantly decreased compared with the control group （6.51~1.47）（P〈0.05）, VAS scores of the observation group after 12 months（3.72~0.96） was significantly decreased compared with the control group （5.934-1.38） （P 〈0.01）. CA 125 of the observation group （26.3~7.2） after treatment was significantly lower than that in the control group（36.74-9.6） （P〈0.05）, FSH, LH, E2 of the two groups after surgery had no significant statistical difference （P〉0.05）. After treatment, patients of observation group had complete remission in 27 cases, significantly alleviate the six cases, partial remission in two cases, therapy patients, the overall response rate（97.22%） was significantly better than that in the control group（91.66%） （P〈0.05）. Conclusion Laparoscopic surgery levonorgestrel-releasing intrauterine system in the treatment of endometriosis can effectively improve the clinical symptoms of endometriosis and help to reduce the recurrence.