摘要
目的：比较子宫内膜异位症腔镜保守性手术术后应用不同药物的疗效及安全性。方法选择165例符合入组标准的子宫内膜异位症患者作为研究对象，所有患者均行腔镜保守性手术，根据术后使用药物不同按随机数字表法分为Ⅰ组（戈舍瑞林），Ⅱ组（米非司酮），Ⅲ组（孕三烯酮），每组各55例，观察临床疗效及安全性。结果Ⅰ组治疗后 E2、CA125、EMAb、痛经 VAS 评分分别为（136．7±3．8）pmol／L、（18．0±2．8）u／mL、（200．8±52．1）pg／mL、（1．91±0．35）分，Ⅱ组分别为（155．0±3．5）pmol／L、（29．4±3．3）u／mL、（265．1±49．8）pg／mL、（1．98±0．44）分，Ⅲ组分别为（158．0±3．2）pmol／L、（31．1±3．5）u／mL、（278．2±45．6）pg／mL、（1．95±0．45）分，均明显低于治疗前（tⅠ组＝10．257、9．029、13．311、7．802，tⅡ组＝8．441、7．083、10．54、6．703，tⅢ组＝7．702、6．448、8．671、6．784，均 P ＜0．01），三组治疗后 E2、CA125、EMAb 差异均有统计学意义（F ＝11．375、8．002、7．671，均 P ＜0．01），Ⅰ组治疗后 E2、CA125、EMAb 明显低于Ⅱ组、Ⅲ组（tⅠ组-Ⅱ组＝3．562、5．017、3．631，tⅠ组-Ⅲ组＝3．268、4．573、4．023，均 P ＜0．05）；Ⅰ组临床总有效率为90．91％，明显高于Ⅱ组、Ⅲ组（χ2＝10．456，P ＜0．05）；Ⅰ组1年妊娠率为50．91％，明显高于Ⅱ组、Ⅲ组（χ2＝7．700，P ＜0．05）。Ⅰ组不良反应发生率为18．18％，Ⅱ组为3．64％，Ⅲ组为29．09％（χ2＝12．732，P ＜0．01）。结论子宫内膜异位症腔镜保守性手术术后应用戈舍瑞林治疗效果确切，且治疗依从性更好，复发率及不良反应发生率更低，妊娠成功率更高，但米非司酮具有更好的经济性及安全性，应根据患者具体情况选用。
Objective To compare the efficacy and safety of different drugs in the treatment of patients with endometriosis by laparoscopic conservatism operation.Methods 165 patients with endometriosis met the inclusion were included as research subjects.All patients were treated with laparoscopic conservatism operation,then were divided intoⅠgroup （goserelin）,Ⅱ group （mifepristone）,Ⅲ group （gestrinone）according to different postoperative medication,55 cases in each group.The clinical efficacy and safety were observed.Results The E2 ,CA125,EMAb,dysmenorrhea VAS scores of Ⅰ group after treatment were （136.7 ±3.8）pmol/L,（18.0 ±2.8）u/mL,（200.8 ± 52.1）pg/mL,（1.91 ±0.35）points,those of Ⅱ group were （155.0 ±3.5）pmol/L,（29.4 ±3.3）u/mL,（265.1 ± 49.8）pg/mL,（1.98 ±0.44）points,those of Ⅲ group were （158.0 ±3.2）pmol/L,（31.1 ±3.5）u/mL,（278.2 ± 45.6）pg/mL,（1.95 ±0.45）points,those in three groups after treatment were significantly lower than before treatment（tⅠgroup =10.257,9.029,13.311,7.802,tⅡgroup =8.441,7.083,10.54,6.703,tⅢgroup =7.702,6.448,8.671, 6.784,all P 〈0.01）.There were significant differences between the three groups in E2 ,CA125,EMAb（F =11.375, 8.002,7.671,all P 〈0.01）.The E2 ,CA125,EMAb ofⅠgroup after treatment were significantly lower than Ⅱ,Ⅲgroup（tⅠgroup -ⅡgrouP =3.562,5.017,3.631,tⅠgroup -Ⅲ group =3.268,4.573,4.023,all P 〈0.05）.The total effective rate of I group was 90.91%,which was significantly higher than Ⅱgroup,Ⅲ group（χ2 =10.456,P 〈0.05）.The 1 -year pregnancy rate of I group was 50.91%,which was significantly higher than Ⅱgroup,Ⅲ group（χ2 =7.700,P 〈0.05）.The incidence rate of adverse reactions of I group was 18.18%,which of Ⅱ group was 3.64%,which of Ⅲgroup was 29.09%（χ2 =12.732,P 〈0.01）.Conclusion The goserelin has exact effect in the treatment of patients with endometriosis by laparoscopic conservatism operation,and has better treatment compliance,lower relapse rate and incidence of adverse reactions,higher pregnancy success rate,but the mifepristone has better economy and safety,the patients should be selected according to specific circumstances.
出处
《中国基层医药》
CAS
2015年第22期3364-3367,共4页
Chinese Journal of Primary Medicine and Pharmacy
