GnRH-a联合优思明对子宫腺肌症行宫腔镜子宫内膜电切术治疗疗效影响和安全性评价

Evaluation of the Efficacy and Safety of GnRH-a in Combination with Ursamine in the Treatment of Adenomyosis by Hysteroscopic Endometrial Electrosurgery

目的:探究GnRH-a联合优思明对子宫腺肌症行宫腔镜子宫内膜电切术治疗疗效影响和安全性。方法:选取本院2016年3月至2021年3月接诊的107例子宫腺肌症患者。简单随机分组法分为对照组(53例,皮下注射3.75mg GnRH-a,1次/4周,共治疗3个月)和观察组(54例,皮下注射3.75mg GnRH-a,1次/4周+优思明,1片/次,连续服用21d后停用7d,共治疗3个月)。手术前与治疗后3个月统计疼痛评分、子宫体积、月经量、卵巢功能;统计治疗3个月后的临床疗效与治疗期间的不良不反应;统计12个月内的复发情况。结果:治疗3个月后,观察组患者的VAS、子宫体积、PBAC、FSH与LH的水平低于对照组(P<0.05)。观察组患者的疗效优于对照组(P<0.05)。观察组的不良反应总发生率与复发率低于对照组(P<0.05)。结论:子宫腺肌症行宫腔镜子宫内膜电切术治疗后使用GnRH-a联合优思明进行后续治疗的疗效确切,可以有效缓解患者痛经程度,恢复卵巢功能,并且可以降低术后不良反应的发生,可在一定程度上降低复发率。

Objective:To explore the efficacy and safety of GnRH-a combined with ursamine in the treatment of adenomyosis by hysteroscopic endometrial resection.Methods:107 patients with adenomyosis treated in our hospital from March 2016 to March 2021 were selected and randomly divided into control group(53cases,subcutaneous injection of 3.75mg GnRH-a,once/4 weeks,a total of 3 months)and observation group(54 cases,subcutaneous injection of 3.75mg GnRH-a,once/4 weeks+ursamine,1 tablet/time,stopped for 7 days after 21 days,a total of 3 months).The pain score,uterine volume,menstrual volume,and ovarian function were counted before operation and 3 months after treatment.The clinical efficacy after 3months of treatment and adverse reactions during treatment were counted.The recurrence within 12 months was counted.Results After 3 months of treatment,the levels of vas,uterine volume,PBAC,FSH,and LH in the observation group were lower than those in the control group(P<0.05).The curative effect of the observation group was better than that of the control group(P<0.05).The total incidence and recurrence rate of adverse reactions in the observation group were lower than those in the control group(P<0.05).Conclusion:The follow-up treatment of adenomyosis with GnRH-a combined with ursamine after hysteroscopic endometrial resection is effective,which effectively alleviates the degree of dysmenorrhea,and restores ovarian function,reduces the incidence of postoperative adverse reactions,and reduces the recurrence rate to a certain extent.