对比术后应用促性腺激素释放激素和孕三烯酮治疗子宫内膜异位症患者的临床效果和安全性
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摘要
目的比较子宫内膜异位症术后患者采用孕三烯酮与促性腺激素释放激素治疗的有效性及安全性。方法选取接受手术治疗的子宫内膜异位症患者80例,按照随机数字表法分为孕三烯酮组与促性腺激素释放激素组各40例,分析两组临床疗效、不良反应以及治疗后体内激素水平情况。结果促性腺激素释放激素组研究对象的总有效率(95.00%)高于孕三烯酮组(62.50%),差异有统计学意义(P<0.05)。促性腺激素释放激素组卵泡刺激素、黄体生成素、催乳素以及雌二醇明显高于孕三烯酮组,差异有统计学意义(P<0.05)。促性腺激素释放激素组不良反应发生率(7.50%)低于孕三烯酮组(35.00%),差异有统计学意义(P<0.05)。结论促性腺激素释放激素治疗子宫内膜异位症效果显著,改善患者激素水平,明显优于孕三烯酮,安全可靠,不良反应少,值得推广应用。
Objective To analyze the safety and efficacy of gestrinone and gonadotropin-releasing hormone therapy in endometriosis patients after surgery. Methods Eighty patients who accepted endometriosis surgery were randomly divided into gestrinone group and gonadotropin-releasing hormone group( n = 40 respectively). Clinical efficacy,hormone levels and adverse reactions were compared between groups after treatment. Results The overall response rate of gonadotropin-releasing hormone group( 95. 00%) was obviously higher than that of gestrinone group( 62. 50%),the difference was statistically significant( P <0. 05). Levels of follicle stimulating hormone,luteinizing hormone,prolactin and estradiol in gonadotropin-releasing hormone group were obviously higher than that of gestrinone group,the difference was statistically significant( P <0. 05). Adverse reactions of gonadotropin-releasing hormone group( 7. 50%) was less than that of gestrinone therapy( 35. 00%),the difference was statistically significant( P < 0. 05). Conclusion Gonadotropin-releasing hormone therapy can effectively treat endometriosis and improve hormone levels,which are significantly superior to gestrinone,it is safe and reliable,and has less adverse reactions,suggesting a wide application.
Objective To analyze the safety and efficacy of gestrinone and gonadotropin-releasing hormone therapy in endometriosis patients after surgery. Methods Eighty patients who accepted endometriosis surgery were randomly divided into gestrinone group and gonadotropin-releasing hormone group( n = 40 respectively). Clinical efficacy,hormone levels and adverse reactions were compared between groups after treatment. Results The overall response rate of gonadotropin-releasing hormone group( 95. 00%) was obviously higher than that of gestrinone group( 62. 50%),the difference was statistically significant( P <0. 05). Levels of follicle stimulating hormone,luteinizing hormone,prolactin and estradiol in gonadotropin-releasing hormone group were obviously higher than that of gestrinone group,the difference was statistically significant( P <0. 05). Adverse reactions of gonadotropin-releasing hormone group( 7. 50%) was less than that of gestrinone therapy( 35. 00%),the difference was statistically significant( P < 0. 05). Conclusion Gonadotropin-releasing hormone therapy can effectively treat endometriosis and improve hormone levels,which are significantly superior to gestrinone,it is safe and reliable,and has less adverse reactions,suggesting a wide application.
引文
[1]张庆霞,李喜英,张蕴霞,等.重度子宫内膜异位症术后使用GnRH-a与孕三烯酮的临床观察[J].实用妇产科杂志,2015,31(2):153-155.
[2]陈灿,王冰.子宫内膜异位症诊断与治疗进展[J].中华实用诊断与治疗杂志,2014,28(2):114-115.
[3]Vercellini P,Crosignani P,Somigliana E,et al.Waiting for Godot':a commonsense approach to the medical treatment of endometriosis[J].Human Reproduction(0xford,England),2011,26(1):3-13.
[4]陶爱群.腹腔镜联合孕三烯酮治疗子宫内膜异位症临床疗效观察[J].中国计划生育学杂志,2012,20(11):777-778.
[5]李雷,冷金花.子宫内膜异位症及其治疗对女性生育影响的研究进展[J].中国实用妇科与产科杂志,2013,29(5):393-396.
[6]徐肖文,王乐丹,朱雪琼,等.卵巢子宫内膜异位症复发后保守治疗的临床对比观察[J].中华医学杂志,2011,91(15):1047-1050.
[7]Vitobello D,Fattizzi N,Santoro G,et al.Robotic surgery and standard laparoscopy:a surgical hybrid technique for use in colorectal endometriosis[J].J Obstet Gynaecol Res,2013,39(1):217-222.
[8]徐丽.子宫内膜异位症患者术后应用促性腺激素释放激素和孕三烯酮的疗效对比分析[J].临床和实验医学杂志,2015,14(3):221,224.
[9]韩星梅,陈燕,杜亚伟,等.中重度子宫内膜异位症术后不同药物治疗患者的生存质量分析[J].中国妇幼保健,2011,26(11):1727-1729.
[10]胡晓军,刘玉玲,党群,等.重度子宫内膜异位症腹腔镜手术后应用GnRHa及反向添加疗法的临床效果[J].实用医学杂志,2014,30(4):557-560.
[11]Alonso Pacheco L,Ramírez Plaza CP,Blanco Reina F,et al.Laparoscopic approach of primary bladder endometriosis[J].Arch Esp Urol,2014,67(6):572-575.
[12]伍倩,唐庆年.子宫内膜异位症术后应用GnRH-α与孕三烯酮的临床疗效比较[J].浙江临床医学,2013,15(2):170-172.
[13]周曦,陈忠东.子宫内膜异位症腹腔镜手术后应用促性腺激素释放激素类似物及反加疗法的疗效观察[J].中国妇幼保健,2015,30(22):3904-3906.
[14]王麟淞,王秀丽.中重度子宫内膜异位症术后应用孕三烯酮治疗的效果评价[J].中国妇幼保健,2014,29(18):2864-2866.
[15]张文缓,侯丽.子宫内膜异位症术后复发相关因素及保守治疗的疗效观察[J].现代中西医结合杂志,2013,22(4):371-372.
[16]Lessey BA.Medical management of endometriosis and infertility[J].Fertil Steril,2011,73(6):1089-1096.
[17]刘霞,张红霞,王丽萍,等.不同剂量长效曲普瑞林对子宫内膜异位症[J].中华医学杂志,2013,93(3):208-211.
[18]孙飞,姜锋,尹国武,等.GnRH-a与孕三烯酮在腹腔镜治疗内膜异位术后用药预防复发的疗效比较[J].陕西医学杂志,2014,43(12):1582,1592.
[19]袁明,汪雯雯,高玲,等.长效GnRHa预防卵巢子宫内膜异位症术后复发的疗效[J].中国妇幼保健,2013,28(30):5052-5055.
[2]陈灿,王冰.子宫内膜异位症诊断与治疗进展[J].中华实用诊断与治疗杂志,2014,28(2):114-115.
[3]Vercellini P,Crosignani P,Somigliana E,et al.Waiting for Godot':a commonsense approach to the medical treatment of endometriosis[J].Human Reproduction(0xford,England),2011,26(1):3-13.
[4]陶爱群.腹腔镜联合孕三烯酮治疗子宫内膜异位症临床疗效观察[J].中国计划生育学杂志,2012,20(11):777-778.
[5]李雷,冷金花.子宫内膜异位症及其治疗对女性生育影响的研究进展[J].中国实用妇科与产科杂志,2013,29(5):393-396.
[6]徐肖文,王乐丹,朱雪琼,等.卵巢子宫内膜异位症复发后保守治疗的临床对比观察[J].中华医学杂志,2011,91(15):1047-1050.
[7]Vitobello D,Fattizzi N,Santoro G,et al.Robotic surgery and standard laparoscopy:a surgical hybrid technique for use in colorectal endometriosis[J].J Obstet Gynaecol Res,2013,39(1):217-222.
[8]徐丽.子宫内膜异位症患者术后应用促性腺激素释放激素和孕三烯酮的疗效对比分析[J].临床和实验医学杂志,2015,14(3):221,224.
[9]韩星梅,陈燕,杜亚伟,等.中重度子宫内膜异位症术后不同药物治疗患者的生存质量分析[J].中国妇幼保健,2011,26(11):1727-1729.
[10]胡晓军,刘玉玲,党群,等.重度子宫内膜异位症腹腔镜手术后应用GnRHa及反向添加疗法的临床效果[J].实用医学杂志,2014,30(4):557-560.
[11]Alonso Pacheco L,Ramírez Plaza CP,Blanco Reina F,et al.Laparoscopic approach of primary bladder endometriosis[J].Arch Esp Urol,2014,67(6):572-575.
[12]伍倩,唐庆年.子宫内膜异位症术后应用GnRH-α与孕三烯酮的临床疗效比较[J].浙江临床医学,2013,15(2):170-172.
[13]周曦,陈忠东.子宫内膜异位症腹腔镜手术后应用促性腺激素释放激素类似物及反加疗法的疗效观察[J].中国妇幼保健,2015,30(22):3904-3906.
[14]王麟淞,王秀丽.中重度子宫内膜异位症术后应用孕三烯酮治疗的效果评价[J].中国妇幼保健,2014,29(18):2864-2866.
[15]张文缓,侯丽.子宫内膜异位症术后复发相关因素及保守治疗的疗效观察[J].现代中西医结合杂志,2013,22(4):371-372.
[16]Lessey BA.Medical management of endometriosis and infertility[J].Fertil Steril,2011,73(6):1089-1096.
[17]刘霞,张红霞,王丽萍,等.不同剂量长效曲普瑞林对子宫内膜异位症[J].中华医学杂志,2013,93(3):208-211.
[18]孙飞,姜锋,尹国武,等.GnRH-a与孕三烯酮在腹腔镜治疗内膜异位术后用药预防复发的疗效比较[J].陕西医学杂志,2014,43(12):1582,1592.
[19]袁明,汪雯雯,高玲,等.长效GnRHa预防卵巢子宫内膜异位症术后复发的疗效[J].中国妇幼保健,2013,28(30):5052-5055.