戈舍瑞林联合替勃龙治疗子宫内膜异位症的临床效果

Clinical Effect of Goserelin Combined with Tibolone in the Treatment of Endometriosis

目的探讨戈舍瑞林联合替勃龙治疗子宫内膜异位症的临床效果。方法回顾性分析2017年5月—2018年6月收治的108例子宫内膜异位症患者,根据患者治疗方案分为A组30例、B组42例以及C组36例。A组采用腹腔镜保守手术治疗,B组在A组的基础上给予戈舍瑞林治疗,C组在A组的基础上给予戈舍瑞林联合替勃龙治疗。比较3组的临床疗效、妊娠情况、血清癌抗原125(CA125)水平、抗子宫内膜抗体(EMAb)阳性率以及不良反应情况。结果B组和C组的治疗总有效率均高于A组(P<0.05)。B组的治疗总有效率与C组比较差异无统计学意义(P>0.05)。3组的妊娠率比较差异无统计学意义(P>0.05)。治疗后,3组的血清CA125水平和EMAb阳性率均低于治疗前,且B组和C组均低于A组(P<0.05)。B组和C组的Kupperman评分高于A组,且B组高于C组(P<0.05)。B组的潮热多汗、烦躁失眠、肌肉骨关节痛、骨量减少发生率高于A组,潮热多汗、烦躁失眠发生率高于C组(P<0.05)。结论子宫内膜异位症行腹腔镜保守手术后,采用戈舍瑞林药物治疗,能够明显提高治疗效果,反向添加替勃龙可明显改善雌激素低水平导致的围绝经期症状,耐受性更好。

Objective To explore the clinical effect of Goserelin combined with Tibolone in the treatment of endometriosis.Methods A retrospective analysis of clinical data of 108 patients with endometriosis admitted from May 2017 to June 2018 was performed.They were divided into group A(n=30),group B(n=42)and group C(n=36)according to the treatment plan of the patients.Group A was treated with conservative laparoscopic surgery,group B was given Goserelin on the basis of group A,and group C was given Goserelin combined with Tibolone on the basis of group A.The clinical efficacy,pregnancy status,serum cancer antigen 125(CA125)level,anti-endometrial antibody(EMAb)positive rate and adverse reactions were compared among the three groups.Results The total effective rate of treatment in group B and group C were higher than that in group A(P<0.05).There was no significant difference in the effective rate between group B and group C(P>0.05).No statistically significant difference was found in pregnancy rate among the three groups(P>0.05).After treatment,the serum CA125 level and EMAb positive rate of the three groups were lower than those before treatment,and group B and group C were lower than group A(P<0.05).The Kupperman scores of group B and group C were higher than those of group A,which was higher in group B than in group C(P<0.05).The incidence of hot flashes and sweating,irritability and insomnia,musculoskeletal joint pain,bone mass reduction in group B was higher than that in group A,and the incidence of hot flashes and sweating,irritability and insomnia in group B was higher than that in group C(P<0.05).Conclusion After conservative laparoscopic surgery for endometriosis,Goserelin drug treatment can significantly improve the treatment effect.Reverse addition of Tibolone can significantly improve perimenopausal symptoms caused by low estrogen levels,with better tolerance.