子宫内膜异位症根治术后激素替代治疗疗效观察

The effects and safety of hormone replacement therapy on women with endometriosis and underwent hysterectomy and bilateral salpingo-oophorectomy

目的 探讨激素替代治疗Ⅲ～Ⅳ期子宫内膜异位症根治术后 (全子宫及双侧附件切除术后 )的临床疗效与安全性。方法 2 0 0 1年 3月至 2 0 0 2年 12月将 30例患者随机分成两组 (各 15例 ) :观察组口服戊酸雌二醇0 5～ 1 0mg ,每日 1次。对照组口服利维爱 1 2 5mg ,每日或隔日 1次。治疗前后检查盆腔情况、肝肾功能、体内血清FSH(卵泡刺激素 )、血清E2 (雌二醇 )水平 ,记录治疗期间盆腔痛、性交痛等子宫内膜异位症相关症状和乳房胀痛等不良反应 ,Kupperman评分 (K评分 )每月 1次。 结果 两组用药后围绝经期症状均明显改善 ,无子宫内膜异位症复发表现 ,血浆E2 水平上升 ,治疗前后比较差异有显著性意义 (P <0 0 1)。治疗后E2 水平观察组高于对照组 ,两组比较差异有显著性意义 (P <0 0 1) ,但均在安全范围内。结论 小剂量戊酸雌二醇和利维爱用于Ⅲ～Ⅳ期子宫内膜异位症根治术后患者 ,均能安全、有效地控制围绝经期症状。

Objective To estimate the recurrence of endometriosis and clinical effects after administration of hormone replacement therapy (HRT) among women who have had endometriosis and underwent hysterectomy and bilateral salpingo oophorectomy (BSO).Methods 30 patients were divided into two groupes randomly.15 received livial 1 25mg every other day or every day orally,and 15 received estradiol valerate 0 5～1 0mg every day orally.Periodical clinical examination,vaginal ultrasound,radiographic examination of breast were performed,and the level of E 2、FSH and the symptoms of endometriosis were recorded.Kupperman score were observed before and after treatment between two groups.Results After treatment,there was no recurrence in two groups.The symptoms of perimenopause were significantly improved in both groups(P<0 01),and the level of E 2 significantly increased in two groups(P<0 01).The group who received estradiol valerate had higher level of E 2 than the group who received livial(P<0 05).Conclusion The low dose estradiol valerate and livial can relieve climacteric symptoms safely on women who have had endometriosis and underwent hysterectomy and bilateral salpingo oophorectomy.