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促性腺激素释放激素与地屈孕酮片预防子宫内膜息肉电切术后复发的临床对比研究(1)
http://www.100md.com 2020年5月15日 《中国医药导报》 202014
     [摘要] 目的 對比促性腺激素释放激素与地屈孕酮片预防子宫内膜息肉(EMP)电切术后复发的临床效果。 方法 选取2016年3月~2018年12月新疆医科大学第一附属医院收治的行EMP电切术患者208例,根据随机数字表法将其分为A组(n = 104)和B组(n = 104),其中A组术后给予地屈孕酮片预防治疗,B组术后给予促性腺激素释放激素预防治疗。比较两组患者子宫内膜厚度、生活质量量表(SF-36)、血清性激素指标、复发率及不良反应发生率。结果 两组患者子宫内膜厚度的时间、组间、交互作用比较差异有高度统计学意义(P < 0.01),进一步两两比较,组内比较:术后3、6、12个月,两组子宫内膜厚度均较术前呈依次降低趋势(P < 0.05);组间比较:B组术后3、6、12个月子宫内膜厚度低于A组(P < 0.05)。术后12个月,两组SF-36量表各维度评分均较术前升高,且B组高于A组,差异有统计学意义(P < 0.05)。术后12个月,两组卵泡刺激素、孕酮、雌二醇均较术前降低,且B组低于A组,差异有统计学意义(P < 0.05)。B组随访期间复发率低于A组,差异有统计学意义(P < 0.05)。B组治疗期间不良反应发生率高于A组,差异有统计学意义(P < 0.05)。 结论 与地屈孕酮片预防治疗比较,促性腺激素释放激素预防治疗EMP电切术后患者,可有效改善子宫内膜厚度、生活质量及血清性激素指标,同时还可减少复发,但其用药安全性相对较差,临床可视患者具体耐受度综合用药。

    [关键词] 促性腺激素释放激素;地屈孕酮片;子宫内膜息肉电切术;复发

    [中图分类号] R711.74 [文献标识码] A [文章编号] 1673-7210(2020)05(b)-0086-04

    Clinical comparative study of gonadotropin releasing hormone and Dydrogesterone Tablets in the prevention of recurrence of endometrial polyps after electrotomy

    LI Yan WANG Juan ZHANG Renqi

    Gynecology Clinic, the First Affiliated Hospital of Xinjiang Medical University, Xinjiang Uygur Autonomous Region, Urumqi 830000, China

    [Abstract] Objective To compare the clinical effect of gonadotropin releasing hormone and Dydrogesterone Tablets in the prevention of recurrence of endometrial polyps (EMP). Methods From March 2016 to December 2018, 208 patients with EMP in the First Affiliated Hospital of Xinjiang Medical University were selected from March 2016 to December 2018, they were divided into group A (n = 104) and group B (n = 104) according to the random number table. Group A was given Dydrogesterone Tablets after operation for prevention and group B was given gonadotropin releasing hormone after operation for prevention. The endometrial thickness, quality of life scal (SF-36), serum sex hormone index, recurrence rate and adverse reactions of patients were compared between the two groups. Results There was high significant difference of endometrial thickness in time, group and interaction between the two groups (P < 0.01). Further comparison between the two groups: 3, 6 months and 12 months after the operation, the endometrial thickness of the two groups decreased in turn compared with that before the operation (P < 0.05); that of group B was lower than that of group A (P < 0.05). At 12 months after operation, SF-36 scores in both groups were higher than those before operation, and group B was higher than group A, the differences were statistically significant (P < 0.05). 12 months after operation, follicle-stimulating hormone, progesterone and estradiol in the two groups were lower than those before operation, and group B was lower than group A, the differences were statistically significant (P < 0.05). The recurrence rate in group B was lower than that in group A, the difference was statistically significant (P < 0.05). The incidence of adverse reactions in group B was higher than that in group A, the difference was statistically significant (P < 0.05). Conclusion Compared with the prophylactic treatment of Dydrogesterone Tablets, the prophylactic treatment of gonadotropin releasing hormone can effectively improve the endometrial thickness, quality of life and serum sex hormone indexes, and reduce the recurrence, but its safety is relatively poor. The specific tolerance of the patients can be seen in clinical practice., http://www.100md.com(李燕 王娟 张仁琦)
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