子宫腺肌瘤患者腹腔镜术后应用米非司酮与左炔诺孕酮宫内节育系统的临床效果比较

Comparison of clinical effects of mifepristone and Mirena ring in patients with endometrioma after laparoscopic surgery

目的探讨米非司酮与左炔诺孕酮宫内节育系统应用于子宫腺肌瘤患者腹腔镜术后的临床效果。方法回顾性抽取2019年9月—2021年1月周口市人民医院妇科收治的子宫腺肌瘤患者60例的临床资料,根据术后治疗方式不同分为观察组和对照组,观察组患者术后给予左炔诺孕酮宫内节育系统治疗,对照组术后给予米非司酮治疗。对比两组患者治疗前后月经情况、卵巢功能变化,观察两组治疗后性生活质量和不良反应发生率。结果观察组治疗后痛经评分(4.21±1.79)显著低于对照组(6.11±1.36)(t=4.629,P=0.000);观察组治疗后黄体生成素(LH)血清卵泡刺激素(FSH)和雌二醇(E2)水平(6.02±1.68、5.63±1.22、52.33±5.09)低于对照组(14.21±2.89、7.35±2.21、59.61±4.86)(t=13.419、3.732、5.666,P均=0.000);观察组治疗后性欲望、性兴奋、阴道润滑、高潮、满意度评分(10.23±3.34、6.36±1.17、15.23±5.32、6.82±2.25、15.24±2.65)显著高于对照组(8.26±3.16、5.28±1.31、12.34±4.77、5.24±1.97、13.34±2.57),性交疼痛评分(6.26±3.31)低于对照组(8.34±2.57)(t=2.347、3.368、2.215、2.894、2.819、2.719,P=0.022、0.001、0.031、0.005、0.007、0.009)。结论与米非司酮相比,子宫腺肌瘤患者腹腔镜术后应用左炔诺孕酮宫内节育系统康复效果更佳,且有助于提高性生活质量。

Objective To explore the clinical effects of mifepristone and Mirena ring in patients with endometrioma after laparoscopic surgery.Methods The clinical data of 60 patients with endometrioma admitted to gynecology department of the hospital between September 2019 and January 2021 were retrospectively collected.According to the postoperative treatment method,patients enrolled were divided into observation group(Mirena ring)and control group(mifepristone).The status of menstruation and changes in ovarian function were compared between the two groups.Quality of sexual life and the incidence of adverse reactions were observed after treatment.Results After treatment,the dysmenorrhea score of observation group was(4.21±1.79),significantly lower than(6.11±1.36)of control group(t=4.629,P=0.000).After treatment,the levels of luteinizing hormone(LH),follicle stimulating hormone(FSH)and estradiol(E2)in observation group were(6.02±1.68)IU/L,(5.63±1.22)IU/L and(52.33±5.09)IU/L,lower than those in the control group[(14.21±2.89)IU/L,(7.35±2.21)IU/L and(59.61±4.86)IU/L](t=13.419,3.732,5.666,P=0.000).After treatment,the scores of sexual desire,sexual excitement,vaginal lubrication,orgasm and satisfaction of observation group were(10.23±3.34),(6.36±1.17),(15.23±5.32),(6.82±2.25)and(15.24±2.65),significantly higher than those of the control group[(8.26±3.16),(5.28±1.31),(12.34±4.77),(5.24±1.97)and(13.34±2.57)],and dyspareunia score was(6.26±3.31),lower than(8.34±2.57)of the control group(t=2.347,3.368,2.215,2.894,2.819,2.719,P=0.022,0.001,0.031,0.005,0.007,0.009).Conclusion Compared with mifepristone,Mirena ring can achieve better recovery effect in patients with endometrioma after laparoscopic surgery,which is beneficial to improve the quality of sexual life.