子宫腺肌瘤术后序贯应用GnRH-a和优思明疗效观察

The Sequential Application of GnRH-a,Yasmin after the Operation of Uterine Adenomyoma to Observe the Curative Effect

序贯应用促性腺激素释放激素激动剂(GnRH-a),屈螺酮炔雌醇(优思明)做为子宫腺肌瘤挖除术后后续治疗方案的治疗效果。选取2010年1月到2013年12月之间在柳州市工人医院妇产科行腹腔镜或开腹子宫腺肌瘤挖除术患者,按术后治疗方案分为A组(GnRH-a)、B组(GnRH-a+优思明)和C组(观察),随访2年对比各组疗效。结果 A组、B组、C组症状复发率分别为12%、4%、27%。术后各组子宫体积明显缩小,月经量评分(PBAC评分)明显下降(P<0.05),随访第1年及第2年A、B组PBAC评分及VAS疼痛评分明显低于C组。B组子宫缩小比例明显大于C组。子宫腺肌瘤病灶切除术后应用GnRH-a能缓解痛经,减少月经量,使子宫体积缩小,序贯联合应用优思明可减轻GnRH-a副作用,为子宫腺肌瘤患者带来更好的临床治疗策略,降低远期复发率。

To observe the curative effect of the sequential application of Gonadotropin releasing hormone agonist（GnRH-a）,Drospirenone and Ethinylestradiol Tablets（Yasmin）after the operation of uterine adenomyoma.The patients who were after the operation of uterine adenomyoma through Laparoscopy or laparotomy from January 2010 to December 2013 in Liuzhou Worker＇s Hospital Department of Obstetrics and Gynecology,according to the treatment plan after surgery were divided into A group（GnRH-a）,B group（GnRH-a＋Yasmin）,C group（observation）,followed up for 2 years,compared the curative effect of each group.A,B,C group of symptoms＇ recurrence rate were 12%,4%,27%.After surgery,the uterine volume was significantly reduced,the menstrual volume score（PBAC score）decreased significantly（P〈0.05）.The PBAC score and VAS pain score of A and B group were significantly lower than those of C group after first years and2 years follow-up.The proportion of uterine contraction in group B was significantly larger than that in group C.The application of GnRH-a after uterine adenomyoma lesion resection can alleviate dysmenorrhea,decrease menstruation,uterine volume was reduced,sequential combined application of Yasmin can reduce the side effect of GnRH-a,the clinical treatment will be a better strategy for patients with uterine adenomyoma,can reduce long-term recurrence rate.