放置依托孕烯植入剂缓解子宫内膜异位症和子宫腺肌病临床症状的疗效观察

Observation of curative effect of etonogestrel implant for relieving the clinical symptoms of endometriosis and adenomyosis of in women

目的:探讨依托孕烯植入剂用于子宫内膜异位症(EM)和子宫腺肌病(AM)缓解痛经等临床症状的疗效。方法:以2016年5月-2017年10月放置依托孕烯植入剂避孕的EM患者44例和AM患者56例为研究对象,观察放置前及放置后1,6,12,24个月的痛经、月经量改变等情况。结果:放置依托孕烯植入剂后,患者痛经VAS评分由放置前的(6.4±2.4)分;降至放置后6,12,24个月的(0.6±0.4)、(0.4±0.9)、(0.2±0.7)分;放置6,12,24个月闭经/月经稀发的发生率分别为54.7%,57.5%,58.1%,与放置前相比较有差异(P<0,05);副作用主要表现为点滴出血(24%)、闭经/月经稀发(58.1%)、体重增加(19.0%)、痤疮(13.0%)等。结论:依托孕烯植入剂适用于痛经和(或)月经过多的EM和AM患者。出血模式改变,包括闭经/月经稀发、不规则和(或)点滴出血是最主要的副反应,也是停止使用的最主要原因。

Objective:To investigate the curative effect of etonogestrel implant for relieving the clinical symptoms of women with endometriosis and adenomyosis.Methods:44 women with endometriosis and 56 women with adenomyosis who had implanted etonogestrel implant from May 2016 to October 2017 were enrolled in this study.The changes of dysmenorrhea,menstrual volume and so on of women before and 1,6,12,24 months after etonogestrel implant used were observed.Results:After etonogestrel implant used,VAS scores of dysmenorrhea of women had decreased from 6.4±2.4 before implanted to 0.6±0.4,0.4±0.9,or 0.2±0.7 in 6,12,or 24 months after implanted.The incidence of amenorrhea of menstruation of women in 6,12 and 24 months after implanted were 54.7%,57.5%,or 58.1%,respectively,which had significant different from that before implanted(P<0.05).The main side effects included spotting bleeding(24%),amenorrhea or menstruation(58.1%),weight gain(19.0%),and acne(13.0%),etc.Conclusion:Etonogestrel implant is suit for women with endometriosis and adenomyosis.Changes in bleeding patterns,such as amenorrhea or oligomenorrhea,irregular and/or spotting,were the most common side effects of etonogestrel implants,and were also the main causes of discontinuation.