地诺孕素治疗复发性卵巢子宫内膜异位囊肿的临床研究

Clinical efficacy of dienogest in treatment of recurrent ovarian endometriosis

目的探究地诺孕素在治疗复发性卵巢子宫内膜异位囊肿(OEM)患者的有效性及安全性。方法选取2020年1月至2021年12月北京市海淀区妇幼保健院妇科门诊收治的OEM异位囊肿剥离术后复发患者54例,随机接受地诺孕素或者复方口服避孕药治疗48周。对比2组患者治疗前、治疗后3月、治疗后6月及治疗后12月疼痛情况、CA125水平及囊肿大小及随访12个月内的不良反应发生情况。结果2组患者的慢性盆腔痛、性交痛、痛经、CA125水平、囊肿大小皆随治疗时间延长,呈现下降趋势(P<0.05),地诺孕素组下降趋势更明显(P<0.05);为期一年的随访过程中,2组患者不良反应差异无统计学意义(P>0.05),未对不良反应进行针对性治疗,症状皆逐渐减轻至消失。结论与复方口服避孕药相比,地诺孕素更有效改善复发性卵巢子宫内膜异位囊肿的疼痛,并可缩小病灶、降低血清CA-125水平,安全耐受。

Objective To evaluate the efficacy and safety of dienogest in the treatment of patients with recurrent ovarian endometriosis(OEM).Methods From January 2020 to December 2021,54 patients with recurrence of OEM ectopic cysts who were treated at the Gynecology Clinic of Beijing Haidian Maternal and Child Health Hospital after dissection were selected and randomly assigned to a dienogest group or a combined oral contraceptive pill(COC)group.The two groups of patients were compared for pain status,CA125 level,and cyst size before treated and 3,6,and 12 months after treatment,as well as the incidence of adverse reactions within 12 months of follow-up.Results Chronic pelvic pain,dyspareunia,dysmenorrhea,CA125 level,and cyst size in the two groups showed a downward trend with the prolongation of treatment time(P<0.05),while the decrease trend in the dienogest group was more significant(P<0.05).During the one-year follow-up,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).No targeted treatment was given to adverse reactions,and the symptoms were gradually relieved and disappeared.Conclusion Compared with COC,dienogest is more effective in improving the pain in patients with recurrent ovarian endometrioma cysts,reducing the recurrence of ovarian endometriotic cyst lesions,and decreasing the level of serum CA-125,which is safe and tolerated.