子宫腺肌病病灶切除术后放置曼月乐环与GnRH-a治疗的临床对比研究

A Comparative Study of Placement of Mirena and GnRH-a Treatment after Resection of Adenomyosis Lesions

目的:对比子宫腺肌病病灶切除术后患者放置曼月乐环与促性腺激素释放激素-a(GnRH-a)治疗的临床疗效。方法:选取某院2015年2月~2018年2月接受子宫腺肌病病灶切除术治疗患者130例,根据随机数字表法分为对照组和观察组,术后对照组患者通过GnRH-a治疗,观察组通过曼月乐环治疗,对比两组患者子宫体积、痛经视觉模拟评分法(VAS)得分、月经失血图(PBAC)评分、血清癌胚抗原(CA)125水平、复发率等。结果:手术前两组患者子宫体积、痛经VAS得分、PBAC评分、血清CA125水平对比无统计学差异(P>0.05);手术1年后观察组患者子宫体积明显小于对照组(P<0.05);手术半年后、1年后观察组患者痛经VAS得分、血清CA125水平明显低于对照组(P<0.05);手术90天、半年后、1年后观察组患者PBAC评分、总复发率均明显低于对照组(P<0.05)。结论:与GnRH-a相比,曼月乐环可持久发挥治疗效果,改善子宫腺肌病患者术后子宫内环境,增强子宫正常生理功能恢复能力,抑制子宫腺肌病复发风险。

Objective:To compare the clinical effects between placement of Mirena and treatment with gonadotropin-releasing hormone agonist(GnRH-a)after resection of adenomyosis lesions.Methods:From February 2015 and February 2018,130 patients who underwent resection of adenomyosis lesions were selected and randomly divided into control group and observation group.After operation,the control group were treated with GnRH-a,while the observation group were treated with Mirena.The uterine volume,visual analogue scale(VAS)score of dysmenorrhea,the Pictorial Blood Loss Assessment Chart(PBAC)score,serum carcinoembryonic antigen(CA)125 level,and recurrence rate were compared between the 2 groups.Results:There was no significant difference in uterine volume,dysmenorrhea VAS score,PBAC score and serum CA125 level between the two groups before operation(P>0.05).The uterine volume of the observation group was significantly smaller than that of the control group at 1 year after operation(P<0.05).The dysmenorrhea VAS score and serum CA125 level were significantly lower in the observation group than those of the control group at half a year,1 year after operation(P<0.05).The PBAC scor and total recurrence rate of patients in the observation group were significantly lower than those of the control group at 90d,half a year,1 year after operation(P<0.05).Conclusion:Compared with the GnRH-a,Mirena can play a lasting role in the treatment,improve the intrauterine environment of patients with adenomyosis after operation,enhance the ability to restore normal physiological function of the uterus,and inhibit the risk of recurrence of adenomyosis.