本文選題：左炔諾孕酮宮內(nèi)節(jié)育系統(tǒng) + 促性腺激素釋放激素激動劑　； 參考：《中國藥房》2017年26期

【摘要】：目的:探討在左炔諾孕酮宮內(nèi)節(jié)育系統(tǒng)放置前給予戈舍瑞林治療子宮腺肌病合并重度痛經(jīng)的臨床效果及安全性。方法:選取三亞市計(jì)劃生育技術(shù)服務(wù)中心2014年1月-2016年1月收治的子宮腺肌病合并重度痛經(jīng)患者140例,按抽簽法隨機(jī)分為對照組和觀察組,各70例。兩組患者均在月經(jīng)開始的7 d內(nèi)放置左炔諾孕酮宮內(nèi)節(jié)育系統(tǒng),其中觀察組患者在放置前1周給予醋酸戈舍瑞林緩釋植入劑10.8 mg腹前壁皮下注射。6個(gè)月后進(jìn)行療效評定。比較兩組患者的痛經(jīng)改善情況,治療前后的子宮體積、COX痛經(jīng)癥狀評分量表(CMSS)評分、月經(jīng)量、血紅蛋白(Hb)和糖類抗原125(CA125)含量,以及不良反應(yīng)發(fā)生情況。結(jié)果:觀察組患者的痛經(jīng)改善率為95.71%,顯著高于對照組的81.43%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療前,兩組患者的上述指標(biāo)比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05);治療后,兩組患者的CMSS評分和月經(jīng)量均較治療前顯著降低或減少,Hb含量均較治療前顯著升高,CA125含量均較治療前顯著降低,且觀察組均顯著優(yōu)于對照組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);兩組患者治療前后子宮體積比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。兩組患者的不良反應(yīng)發(fā)生率(10.00%vs.14.29%)比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:左炔諾孕酮宮內(nèi)節(jié)育系統(tǒng)放置前給予戈舍瑞林治療子宮腺肌病合并重度痛經(jīng),可有效緩解患者痛經(jīng)癥狀,減少月經(jīng)量,改善Hb和CA125水平,且未增加不良反應(yīng)發(fā)生風(fēng)險(xiǎn)。
[Abstract]:Objective: to investigate the clinical effect and safety of treatment of adenomyosis with severe dysmenorrhea before intrauterine birth control with levonorgestrel. Methods: 140 cases of adenomyosis complicated with severe dysmenorrhea were selected from January 2014 to January 2016 in Sanya Family Planning Technical Service Center. According to the method of drawing lots, 140 cases were randomly divided into control group and observation group, 70 cases each. In both groups, levonorgestrel intrauterine birth control system was placed within 7 days of menstruation. The patients in the observation group were injected with Goserelin acetate 10.8 mg into anterior abdominal wall 1 week before menstruation, and the curative effect was evaluated 6 months later. The improvement of dysmenorrhea, the score of uterine volume and Cox dysmenorrhea symptom scale (CMSS), menstrual volume, hemoglobin HB) and carbohydrate antigen 125CA125) before and after treatment were compared between the two groups, as well as the occurrence of adverse reactions. Results: the improvement rate of dysmenorrhea in the observation group was 95.71, which was significantly higher than that in the control group (81.43). The difference was statistically significant (P 0.05). Before treatment, there was no significant difference in the above indexes between the two groups. The CMSS score and menstrual volume of the two groups were significantly decreased or decreased compared with those before treatment, and the content of CA125 in the observation group was significantly higher than that before treatment, and the observation group was significantly better than the control group. There was no significant difference in uterine volume between the two groups before and after treatment. There was no significant difference in the incidence of adverse reactions between the two groups (10.00 vs 14.29). Conclusion: the treatment of severe dysmenorrhea with levonorgestrel before placement of levonorgestrel intrauterine birth control system can effectively relieve dysmenorrhea symptoms, reduce menstrual volume, improve HB and CA125 levels, and do not increase the risk of adverse reactions.
【作者單位】： 三亞市計(jì)劃生育技術(shù)服務(wù)中心婦產(chǎn)科;海南省農(nóng)墾三亞醫(yī)院婦產(chǎn)科;
【分類號】：R711.51;R711.71

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