摘要
目的:探讨宫腔镜子宫肌内膜切除联合孕三烯酮治疗子宫腺肌病临床疗效。方法:136例患者随机分为研究组与对照组。研究组72例,采用宫腔镜下内膜基底层及部份肌层电切术,术后辅以孕三烯酮治疗;对照组64例,采用单纯孕三烯酮治疗。随访观察经量、痛经情况,子宫大小,CA125值、复发率、并发症情况。结果:术后6月研究组月经量改善情况、痛经缓解情况与对照组比较差异有非常显著性(P<0.01),子宫体积缩小程度明显优于对照组(P<0.01),CA125下降值两组比较差异有非常显著性(P<0.01)。两组患者停药后6月和12月,研究组复发率明显低于对照组(P<0.01)。两组患者并发症均为孕三烯酮所致肝功能异常。结论:宫腔镜子宫肌内膜切除联合孕三烯酮治疗子宫腺肌病,临床疗效显著,复发率低,是一种治疗新方式。
Objective: To inquire the clinical effect of the treatment on adenomyosis by combined endometrial and partial myometial ablation of video hysteroscopy with Gestrinone. Methods: One hundred and thirty-six cases were divided into two groups randomly. The study group (72 cases) was treated by electrocision in endometrium basal layer and portial myometrium by video hysteroscope, assisted Gestrinone capsules treatment after operation. The control group (64 cases) was treated by Gestrinone capsules only. The follow-up lasted seven to thirty-four months after treatment, including clinical symptoms, uterine volume, serum CA 125 value, relapse rate, and complications. Results: In the follow-up, 66 cases in study group and 59 cases in control group, their menstrual blood volume decreased or stopped. The remission of dysmennorhea was 74.2% in study group and 18.1% in control group, respectively. There was significant difference between two groups in menstrual blood volume and remission of dysmenorrhea (P<0.01). The decreased size of uterine volume in study group was higher than that in control group (P<0.01). After treatment, mean serum CA 125 value was 21±5.3 U/ml and 48±11.3 U/ml in study group and control group, respectively (P<0.01). Relapse rate in study group was lower than control group after six and twelve months' follow-up (P<0.01). No operative complication was investigated, but abnormal liver function caused by Gestrinone capsules occurred in two groups. Conclusions: It is a new approach to combined video hysteroscopy assisted Gestrinone capsules for treatment of adenomyosis with significantly clinical effect and low relapse rate.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2005年第7期424-426,共3页
Journal of Practical Obstetrics and Gynecology
