子宫腺肌病宫腔镜术后两种药物治疗方案的对比研究

A comparative study of two different medicine treatment for adenomyosis after hysteroscopy

目的通过对子宫腺肌病患者行宫腔镜子宫腺肌病病灶切除+子宫内膜电切术后予以醋酸亮丙瑞林(LA)与地诺孕素(DNG)治疗情况进行分析,研究二者在子宫腺肌病治疗过程中的应用价值。方法收集宫腔镜子宫腺肌病病灶切除+子宫内膜电切术治疗的90例子宫腺肌病患者的临床资料,根据术后治疗方案进行分组,其中注射醋酸亮丙瑞林为LA组(45例),口服地诺孕素为DNG组(45例),对比2组患者治疗前后子宫体积、月经量评分、痛经评分、Kupperman评分、糖类抗原125(CA125)数值变化,同时总结两种不同药物治疗后患者随访6个月的不良反应发生情况。结果2组患者治疗后子宫体积明显减小,月经量评分、痛经评分明显下降,血清CA125数值下降,2组比较差异无统计学意义(P>0.05)。DNG组及DNG组患者治疗后Kupperman评分均升高,且LA组明显高于DNG组(P<0.05)。DNG组治疗后随访6个月中出现的不良发应例数更少。结论子宫腺肌病患者采用宫腔镜子宫腺肌病病灶切除+子宫内膜电切术后联合醋酸亮丙瑞林或地诺孕素药物治疗均可有效减小子宫体积、缓解痛经症状,而地诺孕素治疗后患者出现的不良反应更少,依从性更好。

Objective To analyze the value of Leuprolide Acetate(LA)and Dienogest(DNG)in the patients with adenomyosis who underwent hysteroscopic resection of adenomyosis lesions and endometrium electrocision.Methods The clinical data of 90 patients with adenomyosis who received hysteroscopic resection of adenomyosis lesions and endometrium electrocision were analyzed retrospectively.According to the different treatment plan after hysteroscopy,the patients were divided into two groups.The patients who were given an injection of Leuprolide Acetate(LA)after operation were the control group,and the patients who were administered Dienogest(DNG)orally after the operation was the experimental group.The changes of uterine volume,menstrual volume score,dysmenorrhea score,Kupperman score,carbohydrate antigen 125(CA125)were compared before and after treatment.At the same time,the adverse reactions of the patients who were followed up for 6 months were summarized.Results After treatment,the volume of the uterus,menstrual volume score,dysmenorrhea score and serum CA125 value decreased significantly in the two groups,there was no significant difference between the two groups(P>0.05).The Kupperman score was increased after treatment,and the control group was significantly higher than the experimental group(P<0.05).The number of adverse cases during the 6-month follow-up in the experimental group was less.Conclusion Hysteroscopic resection of adenomyosis lesions and endometrium electrocision combined with Leuprolide Acetate and Dienogest can effectively reduce the volume of the uterus,the amount of menstruation and the symptoms of dysmenorrhea.The adverse reactions of patients after treatment with desmogestrol were less and the compliance was better.