Conservative surgery combined with depot medroxyprogesterone acetate in treatment of moderate or severe endometriosis
- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF OBSTETRICS AND GYNECOLOGY
- Issue:
- 1
- DOI:
- 10.3760/j.issn:0529-567X.2005.01.003
- Key Word:
- 甲羟孕酮17-乙酸酯;促性腺素释放激素;子宫内膜异位症
Abstract： 目的探讨长效醋酸甲羟孕酮(DMPA)用于中重度子宫内膜异位症患者保守性手术后巩固治疗的临床效果及副反应.方法将资料完整的中重度子宫内膜异位症行保守性手术治疗的患者94例,分为DMPA组、促性腺激素释放激素激动剂(GnRH-a)组及对照组.DMPA 组34例,术后月经来潮5 d内,深部肌内注射DMPA 150 mg,28～30 d注射1次,共6次;GnRH-a组30例,术后月经来潮5 d内,皮下注射亮丙瑞林3.75 mg,28～30 d注射1次,共6次;对照组30例,术后未用药物治疗.观察治疗前后患者疼痛症状和体征的临床缓解情况、月经变化、体重改变、肝肾功能及性激素水平变化.结果 DMPA组及GnRH-a组患者疼痛症状和体征完全缓解率分别为88%及93%,显著高于对照组的53%,差异有统计学意义(χ2=12.273, P<0.01;χ2=9.604,P<0.01),DMPA组及GnRH-a组患者累积复发率分别为6%及7%,显著低于对照组的27%(χ2=5.222, P<0.05; χ2=4.320, P<0.05),而DMPA组与GnRH-a组比较,差异无统计学意义(χ2=0.488,P>0.05;χ2=0.017,P>0.05).DMPA组用药前雌二醇水平为(200±15)pmol/L,用药后雌二醇水平显著下降至(120±9)pmol/L,但仍维持在卵泡早期水平.GnRH-a组用药前雌二醇水平为(215±16)pmol/L,用药后雌二醇水平显著下降至(62±9)pmol/L,达绝经期水平.结论 DMPA的主要副作用为月经改变、排卵恢复延迟及体重增加.DMPA用于子宫内膜异位症术后的巩固治疗,有效、方便、价廉、依从性高、副作用少.
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