本文選題：卵巢內(nèi)膜囊腫　切入點(diǎn)：醋酸戈舍瑞林緩釋植入劑　出處：《中國(guó)藥房》2017年14期 　論文類型：期刊論文

【摘要】：目的:探討醋酸戈舍瑞林緩釋植入劑(AGRI)治療腹腔鏡卵巢囊腫摘除術(shù)后復(fù)發(fā)卵巢內(nèi)膜囊腫(OEC)的療效及安全性。方法:選取張家港市第一人民醫(yī)院2013年1月-2015年1月行腹腔鏡卵巢囊腫摘除術(shù)后復(fù)發(fā)的OEC患者60例,采用隨機(jī)數(shù)字表法分為對(duì)照組和觀察組,各30例。兩組患者均口服米非司酮片25 mg,qd。對(duì)照組患者口服孕三烯酮膠囊2.5 mg,2次/周;觀察組患者給予AGRI 3.6 mg,皮下注射,1次/月,兩組患者均持續(xù)治療6個(gè)月。觀察兩組患者臨床療效,治療前及治療3、6個(gè)月血清促卵泡激素(FSH)、黃體生成素(LH)、雌二醇(E_2)水平和痛經(jīng)、慢性盆腔痛視覺模擬評(píng)分法(VAS)評(píng)分,觀察兩組患者不良反應(yīng)發(fā)生情況及隨訪12個(gè)月的預(yù)后情況。結(jié)果:觀察組患者臨床總有效率為86.67%,顯著高于對(duì)照組的70.00%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療3個(gè)月,兩組患者FSH、LH水平較治療前顯著降低,差異有統(tǒng)計(jì)學(xué)意義(P0.05),但E_2水平無變化,且FSH、LH組間比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05);治療6個(gè)月,兩組患者FSH、LH、E_2水平均顯著降低,且觀察組顯著低于對(duì)照組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。治療3、6個(gè)月,兩組患者痛經(jīng)、慢性盆腔痛VAS評(píng)分均顯著降低,且觀察組顯著低于對(duì)照組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。觀察組患者不良反應(yīng)發(fā)生率40.00%,顯著高于對(duì)照組的16.70%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組患者復(fù)發(fā)率比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05),但觀察組患者月經(jīng)恢復(fù)正常率為86.67%、優(yōu)勢(shì)卵泡形成率為60.00%、妊娠率為53.33%,顯著高于對(duì)照組的46.67%、46.67%、33.33%,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:AGRI治療腹腔鏡卵巢囊腫摘除術(shù)后復(fù)發(fā)OEC療效顯著,可有效緩解患者痛經(jīng)和慢性盆腔痛,提高妊娠率;停藥后仍有復(fù)發(fā)病例,且不良反應(yīng)發(fā)生率較高,但癥狀輕微。
[Abstract]:Objective: to investigate the efficacy and safety of Gosherrelin Acetate sustained release implantation (AGRI) in the treatment of recurrent ovarian endometrial cysts after laparoscopic ovarian cyst excision. Methods: the first people's Hospital of Zhangjiagang City from January 2013 to January 2015 was selected. There were 60 cases of recurrent OEC after laparoscopic ovarian cyst extirpation. The patients in the control group were divided into the control group and the observation group with 30 cases each. The patients in both groups were given mifepristone tablets 25 mg / d, the control group were given 2. 5 mg of pregnenone capsules twice a week, and the patients in the observation group were given AGRI 3. 6 mg subcutaneously once a month, and the patients in the control group were given subcutaneous injection of mifepristone tablets once a month. The clinical efficacy, serum follicle stimulating hormone (FSH), luteinizing hormone (LHN), estradiol (E _ 2) and VAS-score of dysmenorrhea and chronic pelvic pain were observed in both groups for 6 months. Results: the total effective rate of the patients in the observation group was 86.67, significantly higher than that in the control group (70.005%), and the difference was statistically significant (P 0.05). The level of FSHO LH in the two groups was significantly lower than that before treatment, the difference was statistically significant (P 0.05), but there was no change in the E2 level, and there was no significant difference in the level of FSH LH between the two groups, and after 6 months of treatment, the level of FSH LHN E2 in the two groups was significantly lower than that in the control group, and there was no significant difference in the level of E 2 between the two groups after 6 months of treatment. The VAS scores of dysmenorrhea and chronic pelvic pain in the observation group were significantly lower than those in the control group, and were significantly lower in the observation group than in the control group. The incidence of adverse reactions in the observation group was significantly higher than that in the control group (P 0.05), and the incidence of adverse reactions in the observation group was significantly higher than that in the control group (P 0.05), and the recurrence rate of the two groups was higher than that of the control group (P 0.05). The difference was not statistically significant (P 0.05), but the menstrual recovery rate, dominant follicle formation rate and pregnancy rate in the observation group were 86.67, 60.00and 53.33, respectively, which were significantly higher than those in the control group (46.67g / 46.67g / 33.33g). Except for the postoperative recurrence of OEC, the curative effect was significant. It can effectively relieve dysmenorrhea and chronic pelvic pain and increase pregnancy rate.
【作者單位】： 張家港市第一人民醫(yī)院婦科;張家港市中醫(yī)院婦科;
【分類號(hào)】：R713.6

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