戊酸雌二醇与地屈孕酮联用对子宫内膜异位囊肿患者术后复发及卵巢功能的影响

Effects of Estradiol Valerate Combined with Dydrogesterone on Postoperative Recurrence and Ovarian Function in Patients with Ovarian Endometriosis

目的探讨戊酸雌二醇与地屈孕酮联用对子宫内膜异位囊肿(OEM)患者术后复发及卵巢功能的影响。方法选择行腹腔镜切除手术的100例OEM患者作为研究对象,并按随机数字表法分为对照组(50例)和研究组(50例)。术后对照组应用地屈孕酮治疗,研究组应用戊酸雌二醇联合地屈孕酮治疗,治疗3个月,比较两组疗效、性激素[雌二醇(E_2)、卵泡刺激素(FSH)、黄体生成素(LH)]水平、抗缪勒氏管激素(AMH)水平和不良反应发生率,随访6个月比较两组的复发率和妊娠率。结果治疗后研究组治疗总有效率为94.00%,高于对照组的80.00%(P<0.05);两组E_2、FSH、LH水平均低于同组治疗前,AMH水平高于同组治疗前,且研究组改善程度优于对照组(P<0.05);两组不良反应发生率无明显差异(P>0.05);研究组复发率为2.00%,低于对照组(14.00%),妊娠率(64.00%)高于对照组(40.00%)(P<0.05)。结论戊酸雌二醇联合地屈孕酮对OEM手术的疗效显著,能有效调节性激素水平,提高卵巢功能,减少术后疾病复发,提高妊娠率。

Objective To explore the effects of estradiol valerate combined with dydrogesterone on postoperative recurrence and ovarian function in patients with ovarian endometriosis(OEM).Methods A total of 100 patients with OEM underwent laparoscopic resection were enrolled as the research objects.According to random number table method,they were divided into the control group(50 cases)and the study group(50 cases).After surgery,the control group was treated with dydrogesterone,while the study group was additionally treated with estradiol valerate for 3 months.The curative effect,levels of sex hormones[estradiol(E 2),follicle stimulating hormone(FSH),luteinizing hormone(LH)]and anti-Mullerian hormone(AMH),and the incidence of adverse reactions were compared between the 2 groups.After 6 months of follow-up,recurrence rate and pregnancy rate were compared between the 2 groups.Results After treatment,total response rate of treatment was higher in study group than the control group(94.00%vs 80.00%,P<0.05).After treatment,levels of E 2,FSH and LH were decreased,while AMH level was increased in both groups,and improvement of the above indexes was better in the study group than the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the 2 groups(P>0.05).The recurrence rate in study group was lower than that in the control group(2.00%vs 14.00%),and pregnancy rate was higher than that in the control group(64.00%vs 40.00%,P<0.05).Conclusion Estradiol valerate combined with dydrogesterone has significant curative effect on OEM,which can effectively regulate levels of sex hormones,improve ovarian function,reduce postoperative disease recurrence and increase pregnancy rate.