中重度子宫内膜异位症术后长期口服避孕药的疗效观察

目的探讨口服避孕药对中重度子宫内膜异位症(EMT)术后治疗的疗效及副反应。方法分析2009年1月至2015年1月144例EMT手术患者的临床资料。分为2组,A组(86例)术后3d开始应用促性腺激素释放激素(GnRH-a)0.375mg,1次/28d,连续治疗6个月,第8个月开始周期性口服去氧孕烯炔離醇片(妈富隆),1片/d。B组(58例)术后3d仅应用GnRH-a 0.375mg,1次/28d,连续治疗6个月。随访1次/6个月,连续随访5年。比较两组EMT复发率、痛经和慢性盆腔痛的程度及副反应。结果与B组比较,A组患者子宫内膜异位症的复发率明显降低(P<0.01),痛经和慢性盆腔痛均得到缓解(P<0.05);并且未发现毒副反应。结论口服避孕药可作为EMT术后治疗和预防复发的一种有效药物,且服用方便、价格低廉,值得临床应用推广。

Objective To investigate the eficacy and side effects of oral contraceptives for postoperative treatment of moderate or severe endometriosis(EMT).Methods The follow-up data of 144 inpatients underwent EMT surgery were observed and analyzed postoperatively from January 2009 to January 2015,with an average of Ⅰ fllow-up every 6 months,ollowed up for 5 years.Group A(86 cases)was treated with gonadotropin releasing hormone(GnRH-a)0.375mg,once every 28d,for 6 months.After 8 months,oral administration of desogestrel ethinylestradiol tablets(Marvelon),Ⅰtablet/D,was started in the 8th month.Group B(58 cases)was treated with GnRH-a 0.375 mg once a day for 6 months.The patients were fllowved up for 5 years.The recurrence rate of EMT,the degree of dysmenorrhea and chronic pelvic pain and side efts were compared between the two groups.Results Compared with group B,the recurrence rate of endometriosis in group A was significantly reduced(P<0.01),dysmenorrhea and chronice pelvic pain were lleviated(P<0.05);and no toxic and side ffects were found.Conclusion Oral contraceptives can be used as an efective drug for the treatment and prevention of recurrence after EMT,and it is convenient to ake and low in price.It is worthy of clinical application and promotion.