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腹腔镜术后戈舍瑞林联合戊酸雌二醇治疗育龄期子宫内膜异位症的临床观察
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| 篇名： | 腹腔镜术后戈舍瑞林联合戊酸雌二醇治疗育龄期子宫内膜异位症的临床观察 |
| TITLE： | Clinical observation of goserelin combined with estradiol valerate in the treatment of endometriosis in patients of childbearing age after laparoscopic surgery |
| 摘要： | 目的 观察腹腔镜术后戈舍瑞林联合戊酸雌二醇治疗育龄期子宫内膜异位症（EMs）的疗效和安全性。方法回顾性收集2020年1月－2022年12月在我院接受腹腔镜手术治疗的144例育龄期EMs患者资料，根据术后用药方案分为对照组（70例）和联合组（74例）。对照组患者于腹腔镜手术后首次月经来潮的第1～5天给予醋酸戈舍瑞林缓释植入剂，联合组患者在对照组用药的基础上给予戊酸雌二醇片。观察两组患者的近期疗效和远期疗效，记录术前和术后的疼痛评分、卵巢储备功能及不良反应发生情况。结果两组患者的近期总有效率、术后1年复发率及性欲下降、阴道干涩、胃肠道反应、皮疹、心律失常的发生率比较，差异均无统计学意义（P＞0.05）；联合组患者术后1年自然妊娠率显著高于对照组，早期流产率及潮热出汗、情绪波动、失眠乏力、关节肌肉疼痛、头晕头痛的发生率均显著低于对照组（P＜0.05）。术后6个月，两组患者的疼痛程度评分和抗米勒管激素、卵泡刺激素、黄体生成素、雌二醇水平均显著低于同组术前，窦卵泡计数显著高于同组术前，且联合组的抗米勒管激素、黄体生成素、雌二醇水平和窦卵泡计数均显著高于对照组，疼痛程度评分及卵泡刺激素水平均显著低于对照组（P＜0.05）。结论腹腔镜术后戈舍瑞林联合戊酸雌二醇治疗育龄期EMs疗效显著，且安全性较好。 |
| ABSTRACT： | OBJECTIVE To observe the efficacy and safety of goserelin combined with estradiol valerate in the treatment of endometriosis （EMs） in patients of childbearing age after laparoscopic surgery. METHODS The clinical data of 144 patients with EMs of childbearing age who underwent laparoscopic surgery in our hospital from January 2020 to December 2022 were collected retrospectively， and those patients were divided into control group （70 cases） and combination group （74 cases） based on different postoperative medication regimens. Control group was given Acetate goserelin sustained-release implant on the 1st to 5th day of their first menstrual cycle after laparoscopic surgery， while combination group was additionally given Estradiol valerate tablets on the basis of control group. The short-term and long-term efficacy of 2 groups were observed； preoperative and postoperative pain scores， ovarian reserve function， and the incidence of adverse reactions were all recorded in 2 groups. RESULTS There was no statistically significant difference in short-term total effective rate， 1-year postoperative recurrence rate and the incidence of decreased libido， vaginal dryness， gastrointestinal reactions， rash， or arrhythmia between two groups （P＞0.05）. The natural pregnancy rate of combination group was significantly higher than control group at 1 year after surgery， while the incidence E-mail：wanghuiling0518@126.com of early miscarriage， hot flashes and sweating， emotional fluctuations， insomnia and fatigue， joint muscle pain， dizziness and headache were significantly lower than control group （P＜0.05）. However， at 6 months after surgery， pain scores and the levels of anti-Müllerian hormone， follicle stimulating hormone， luteinizing hormone， estradiol of both groups were significantly lower than before surgery in the same group， while the number of antral follicle count was significantly higher than before surgery in the same group； the levels of anti-Müllerian hormone， luteinizing hormone， estradiol， and the number of antral follicles in the combination group were significantly higher than control group， while pain score and follicle stimulating hormone level were significantly lower than control group （P＜0.05）. CONCLUSIONS The combination of goserelin and estradiol valerate after laparoscopic surgery has a significant therapeutic effect and good safety in the treatment of EMs of childbearing age. |
| 期刊： | 2024年第35卷第14期 |
| 作者： | 王慧玲；马宁；乔磊；杨君；文政芳 |
| AUTHORS： | WANG Huiling，MA Ning，QIAO Lei，YANG Jun，WEN Zhengfang |
| 关键字： | 子宫内膜异位症；腹腔镜手术；戈舍瑞林；戊酸雌二醇；妊娠率；卵巢储备功能；安全性 |
| KEYWORDS： | endometriosis； laparoscopic surgery； goserelin； estradiol valerate； pregnancy rate； ovarian reserve function； safety |
| 阅读数： | 27 次 |
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