醋酸亮丙瑞林微球与地诺孕素片治疗在子宫内膜异位囊肿患者术后的对比研究

A Comparative Study of Leuprorelin Acetate Microspheres and Dienogest Tablets Treatment in Patients with Endometriotic Cysts after Surgery

目的探讨子宫内膜异位囊肿(Endometrioma,EMA)患者手术治疗后应用醋酸亮丙瑞林微球与地诺孕素片的临床价值。方法回顾性选取2021年6月-2022年6月重庆市渝北区妇幼保健院收治的70例EMA患者的临床资料。所有病例均予以手术治疗,按照术后用药方法,将其分为A组(醋酸亮丙瑞林微球治疗,n=35)与B组(地诺孕素片治疗,n=35)。比较两组治疗效果、超声复查结果、卵巢功能变化、不良事件发生率。结果A组治疗总有效率为97.14%,高于B组为91.43%,差异无统计学意义(χ^(2)=1.061,P=0.303)。A组不良事件发生率为25.71%,高于B组的5.71%,差异有统计学意义(χ^(2)=5.285,P=0.022)。治疗后,两组子宫体积、子宫内膜厚度比较,差异无统计学意义(P均>0.05)。治疗后A组窦状卵泡数、早卵泡期抗苗勒管激素指标水平的变化幅度大于B组,差异有统计学意义(P均<0.05)。结论亮丙瑞林与地诺孕素在术后辅助治疗EMA方面均有较好的效果,能够有效降低复发风险,但前者的不良事件风险更高,用药过程中卵巢储备功能所受影响较大,育龄期女性可优先考虑地诺孕素辅助治疗。

Objective To explore the clinical value of the application of leuprorelin acetate microspheres versus dieno-gest tablets after surgical treatment of patients with endometriotic cysts(Endometrioma,EMA).Methods The clinical data of 70 patients with EMA treated in Yubei District Maternal and Child Health Hospital of Chongqing from June 2021 to June 2022 were retrospectively selected.All cases were treated with surgery,and were divided into group A(leuprelin acetate microspheres,n=35)and group B(dinorgestrel tablets,n=35)according to postoperative medication.The therapeutic effect,ultrasound reexamination results,changes in ovarian function and incidence of adverse events were compared between the two groups.Results The total effective rate was 97.14%in group A and 91.43%in group B,and there was no statistically significant difference between the two groups(χ^(2)=1.061,P=0.303).The incidence of adverse events was 25.71%in group A,which was higher than 5.71%in group B,and the difference was statistically significant(χ^(2)=5.285,P=0.022).After treatment,there was no statistically significant difference in uterine volume and endometrial thickness between the two groups(both P>0.05).After treatment,the number of sinusoidal follicles in group A and the level of anti-Mullerian hormone index in early follicle stage were higher than those in group B,and the differences were statistically significant(all P<0.05).Conclusion Both leuprelin and dinorgestrel have good effects in the postoperative adjuvant treatment of EMA,which can effectively reduce the risk of recurrence.However,the for-mer has a higher risk of adverse events,and the ovarian reserve function is greatly affected during the course of admin-istration.Therefore,dinorgestrel adjuvant therapy can be given priority in women of childbearing age.