不同剂量戈舍瑞林长方案联合地诺孕素治疗子宫内膜异位症术后患者的效果比较

Comparison of the Effects of Different Doses of Goserelin Combination with Denogestrin in the Treatment of Postoperative Patients with Endometriosis

目的:探讨低剂量戈舍瑞林长方案联合地诺孕素在子宫内膜异位症(EMT)术后患者中的应用效果。方法:纳入2019年1月—2022年8月医院拟接受手术治疗的80例EMT患者为研究对象,按照随机信封法分为低剂量组和高剂量组,各40例。患者均接受手术治疗,并于术后常规药物干预,低剂量组患者术后使用低剂量(3.6 mg)醋酸戈舍瑞林长方案联合地诺孕素治疗,高剂量组患者术后行高剂量(7.2 mg)醋酸戈舍瑞林长方案联合地诺孕素治疗。比较两组性激素水平[卵泡刺激素(FSH)、雌二醇(E2)、黄体生成素(LH)]、卵巢功能[抗缪勒管激素(AMH)、卵巢窦状卵泡数(AFC)、卵巢体积]、不良反应发生情况及复发情况。结果:治疗6个月后,低剂量组E2水平高于高剂量组(P<0.05),而两组FSH、LH水平比较,差异无统计学意义(P>0.05);低剂量组AMH水平高于高剂量组(P<0.05),而两组AFC值、卵巢体积比较,差异无统计学意义(P>0.05);低剂量组治疗期间不良反应总发生率低于高剂量组(P<0.05);随访期间,两组复发率比较,差异无统计学意义(P>0.05)。结论:相较于高剂量戈舍瑞林长方案联合地诺孕素治疗,低剂量戈舍瑞林长方案在纠正EMT术后激素紊乱状态、改善卵巢功能的同时,可减轻患者低雌激素症状,与高剂量应用的复发率相当,且一定程度上可以减少不良反应的发生,安全性好。

Objective:To explore the application effect of low-dose goserelin combination with denogestrin in postoperative patients with endometriosis(EMT).Method:Eighty EMT patients who were scheduled to undergo surgical treatment in the hospital from January 2019 to August 2022 were included as the study subjects.They were randomly divided into a low-dose group and a high-dose group using a random envelope method,with 40 patients in each group.All patients underwent surgical treatment and received routine medication intervention after surgery.The low-dose group received low-dose(3.6 mg)acetate goserelin long regimen combined with denogestrin after surgery,while the high-dose group received high-dose(7.2 mg)acetate goserelin long regimen combined with denogestrin after surgery.The levels of sex hormones[follicle stimulating hormone(FSH),estradiol(E2),luteinizing hormone(LH)],ovarian function[anti Mullerian hormone(AMH),number of antral follicles(AFC),ovarian volume],incidence and recurrence of adverse reactions were compared between two groups.Result:After 6 months of treatment,the E2 level in the low-dose group was higher than that in the high-dose group(P<0.05),while there was no statistical signifcant diference in FSH and LH levels between the two groups(P>0.05).The AMH level in the low-dose group was higher than that in the highdose group(P<0.05),while there was no statistical signifcant diference in AFC value and ovarian volume between the two groups(P>0.05).The total incidence of adverse reactions during treatment in the low-dose group was lower than that in the high-dose group(P<0.05).During the follow-up period,there was no statistical signifcant diference in recurrence rates between the two groups(P>0.05).Conclusion:Compared to high-dose goserelin combination with denogestrin,low-dose combination therapy can correct hormonal imbalance and improve ovarian function after EMT,alleviate low estrogen symptoms in patients,and have a similar recurrence rate as high-dose application.It can also reduce the occurrence of adverse reactions to some extent and has good safety.