摘要
目的探讨依托孕烯单根皮下埋植剂治疗症状性子宫腺肌病(AM)的临床疗效。方法将60例症状性AM患者随机分为对照组和观察组,各30例。对照组给予醋酸曲普瑞林治疗3个月后,在宫内放置左炔诺孕酮宫内缓释系统;观察组给予依托孕烯单根皮下埋植剂治疗。比较两组患者治疗前、治疗后3个月、6个月、12个月的月经量、痛经程度、子宫体积、子宫内膜厚度,以及治疗前、治疗后3个月、6个月的血清血红蛋白、糖类抗原125(CA125)、前列腺素F2a(PGF2a)、肿瘤坏死因子α(TNF-α)水平。结果在治疗后3个月、6个月、12个月,观察组的月经失血图评分、痛经程度视觉模拟量表评分、子宫大小及子宫内膜厚度均小于或低于对照组(均P<0.05)。在治疗后3个月、6个月,观察组的血红蛋白水平高于对照组,CA125、PGF2a、TNF-α水平均低于对照组(均P<0.05)。结论依托孕烯单根皮下埋植剂治疗症状性AM能更有效地减少子宫内膜厚度和月经量,缓解痛经程度,缩小患者子宫,提高血清血红蛋白水平,并降低血清CA125、PGF2a、TNF-α水平。
Objective To investigate the clinical efficacy of single subcutaneous Etonogestrel Implants for the treatment of symptomatic adenomyosis(AM).Methods Sixty patients with symptomatic AM were randomly divided into control group(30 cases)and observation group(30 cases).The control group was treated with triptorelin acetate for three months prior to intrauterine implantation of the levonorgestrel-releasing intrauterine system;the observation group was given single subcutaneous Etonogestrel Implants.The two groups were compared in terms of menstrual volume,severity of dysmenorrhea,uterus volume,and endometrial thickness before treatment and 3,6,12 months after treatment,as well as serum levels of hemoglobin,carbohydrate antigen 125(CA125),prostaglandin F2a(PGF2a),tumor necrosis factorα(TNF-α)before treatment and 3 and 6 months after treatment.Results Three,6 and 12 months after treatment,the observation group had lower scores on the pictorial blood loss assessment chart(PBAC)and the Visual Analogue Scale(VAS),minor uterine volume,and lower endometrial thickness than the control group(all P<0.05).Three and 6 months after treatment,the observation group exhibited a higher hemoglobin level and lower levels of CA125,PGF2a and TNF-αas compared with the control group(all P<0.05).Conclusion Single subcutaneous Etonogestrel Implants can reduce patients′endometrial thickness and menstrual volume more effectively,ameliorate dysmenorrhea,decrease uterus volume,increase serum hemoglobin level,and decrease serum levels of CA125,PGF2a and TNF-α.
作者
刘一萍
黄建邕
黄英梅
谢宝丽
LIU Yi-ping;HUANG Jian-yong;HUANG Ying-mei;XIE Bao-li(Department of Gynecology,Nanning First People′s Hospital,Nanning 530022,China)
出处
《广西医学》
CAS
2020年第7期801-804,共4页
Guangxi Medical Journal
基金
广西医药卫生科研课题(Z20180667)。
关键词
症状性子宫腺肌病
依托孕烯单根皮下埋植剂
左炔诺孕酮宫内缓释系统
临床疗效
Symptomatic adenomyosis
Single subcutaneous Etonogestrel Implants
Levonorgestrel-releasing intrauterine system
Clinical efficacy
