中华妇产科杂志
中華婦產科雜誌
중화부산과잡지
CHINESE JOUNAL OF OBSTETRICS AND GYNECOLOGY
2013年
7期
508-510
,共3页
子宫内膜异位症%亮丙瑞林%复发%治疗结果
子宮內膜異位癥%亮丙瑞林%複髮%治療結果
자궁내막이위증%량병서림%복발%치료결과
Endometriosis%Leuprolide%Recurrence%Treatment outcome
目的 观察国产注射用醋酸亮丙瑞林微球(其他名称:贝依)预防卵巢内异症囊肿术后复发的近期疗效.方法 回顾性分析复旦大学附属妇产科医院2011年1至9月收治的、且行保守性手术治疗的190例卵巢内异症囊肿患者的临床资料,其中184例完成随访,随访时间12 ～21个月.184例患者中有痛经症状者116例.按术后是否用药分为用药组124例,未用药组60例；用药组再按用促性腺激素释放激素激动剂(GnRH-a)种类的不同分为:国产GnRH-a组63例,术后加用国产GnRH-a(3.75 mg/28 d)治疗；进口GnRH-a组61例,术后加用进口GnRH-a类药物包括戈舍瑞林(其他名称:诺雷德)3.6 mg/28 d、或曲谱瑞林(其他名称:达菲林)3.75 mg/28 d、或亮丙瑞林(其他名称:抑那通)3.75 mg/28 d治疗,疗程3～6个月.比较各组患者保守性手术后的复发情况及疼痛症状改善情况.结果 (1)疾病复发情况:184例患者中,共有23例术后复发,复发率为12.5％(23/184),平均复发时间为(13.7±2.6)个月(2～21个月).术后用药组总复发率为8.1％ (10/124),未用药组复发率为21.7％(13/60),两组比较,差异有统计学意义(P＜0.05)；国产GnRH-a组复发率为7.9％(5/63),进口GnRH-a组复发率为8.2％(5/61),两组比较,差异无统计学意义(P＞0.05).(2)痛经缓解及复发情况:保守性手术后,116例痛经患者中痛经缓解率为87.1％ (101/116),未缓解率12.9％(15/116).痛经缓解后复发者12.9％(13/101).术后痛经缓解率及复发率分别为国产GnRH-a组:89％ (31/35),13％ (4/31)；进口GnRH-a组:86％ (37/43),14％ (5/37)；未用药组:87％(33/38),12％(4/33)；3组间术后痛经缓解率及复发率比较,差异均无统计学意义(P＞0.05).结论 卵巢内异症囊肿保守性手术后加用GnRH-a治疗可以有效减少疾病复发,但对痛经缓解作用不显著.国产GnRH-a与进口GnRH-a类药物疗效相同.
目的 觀察國產註射用醋痠亮丙瑞林微毬(其他名稱:貝依)預防卵巢內異癥囊腫術後複髮的近期療效.方法 迴顧性分析複旦大學附屬婦產科醫院2011年1至9月收治的、且行保守性手術治療的190例卵巢內異癥囊腫患者的臨床資料,其中184例完成隨訪,隨訪時間12 ～21箇月.184例患者中有痛經癥狀者116例.按術後是否用藥分為用藥組124例,未用藥組60例；用藥組再按用促性腺激素釋放激素激動劑(GnRH-a)種類的不同分為:國產GnRH-a組63例,術後加用國產GnRH-a(3.75 mg/28 d)治療；進口GnRH-a組61例,術後加用進口GnRH-a類藥物包括戈捨瑞林(其他名稱:諾雷德)3.6 mg/28 d、或麯譜瑞林(其他名稱:達菲林)3.75 mg/28 d、或亮丙瑞林(其他名稱:抑那通)3.75 mg/28 d治療,療程3～6箇月.比較各組患者保守性手術後的複髮情況及疼痛癥狀改善情況.結果 (1)疾病複髮情況:184例患者中,共有23例術後複髮,複髮率為12.5％(23/184),平均複髮時間為(13.7±2.6)箇月(2～21箇月).術後用藥組總複髮率為8.1％ (10/124),未用藥組複髮率為21.7％(13/60),兩組比較,差異有統計學意義(P＜0.05)；國產GnRH-a組複髮率為7.9％(5/63),進口GnRH-a組複髮率為8.2％(5/61),兩組比較,差異無統計學意義(P＞0.05).(2)痛經緩解及複髮情況:保守性手術後,116例痛經患者中痛經緩解率為87.1％ (101/116),未緩解率12.9％(15/116).痛經緩解後複髮者12.9％(13/101).術後痛經緩解率及複髮率分彆為國產GnRH-a組:89％ (31/35),13％ (4/31)；進口GnRH-a組:86％ (37/43),14％ (5/37)；未用藥組:87％(33/38),12％(4/33)；3組間術後痛經緩解率及複髮率比較,差異均無統計學意義(P＞0.05).結論 卵巢內異癥囊腫保守性手術後加用GnRH-a治療可以有效減少疾病複髮,但對痛經緩解作用不顯著.國產GnRH-a與進口GnRH-a類藥物療效相同.
목적 관찰국산주사용작산량병서림미구(기타명칭:패의)예방란소내이증낭종술후복발적근기료효.방법 회고성분석복단대학부속부산과의원2011년1지9월수치적、차행보수성수술치료적190례란소내이증낭종환자적림상자료,기중184례완성수방,수방시간12 ～21개월.184례환자중유통경증상자116례.안술후시부용약분위용약조124례,미용약조60례；용약조재안용촉성선격소석방격소격동제(GnRH-a)충류적불동분위:국산GnRH-a조63례,술후가용국산GnRH-a(3.75 mg/28 d)치료；진구GnRH-a조61례,술후가용진구GnRH-a류약물포괄과사서림(기타명칭:낙뢰덕)3.6 mg/28 d、혹곡보서림(기타명칭:체비림)3.75 mg/28 d、혹량병서림(기타명칭:억나통)3.75 mg/28 d치료,료정3～6개월.비교각조환자보수성수술후적복발정황급동통증상개선정황.결과 (1)질병복발정황:184례환자중,공유23례술후복발,복발솔위12.5％(23/184),평균복발시간위(13.7±2.6)개월(2～21개월).술후용약조총복발솔위8.1％ (10/124),미용약조복발솔위21.7％(13/60),량조비교,차이유통계학의의(P＜0.05)；국산GnRH-a조복발솔위7.9％(5/63),진구GnRH-a조복발솔위8.2％(5/61),량조비교,차이무통계학의의(P＞0.05).(2)통경완해급복발정황:보수성수술후,116례통경환자중통경완해솔위87.1％ (101/116),미완해솔12.9％(15/116).통경완해후복발자12.9％(13/101).술후통경완해솔급복발솔분별위국산GnRH-a조:89％ (31/35),13％ (4/31)；진구GnRH-a조:86％ (37/43),14％ (5/37)；미용약조:87％(33/38),12％(4/33)；3조간술후통경완해솔급복발솔비교,차이균무통계학의의(P＞0.05).결론 란소내이증낭종보수성수술후가용GnRH-a치료가이유효감소질병복발,단대통경완해작용불현저.국산GnRH-a여진구GnRH-a류약물료효상동.
Objective To evaluate the short-term effect of leuprorelin acetate microspheres in preventing recurrence of ovarian endometrioma after conservative surgery.Methods From January 2011 to September 2011,190 ovarian endometrioma patients undergoing conservative laparoscopic surgery at Affiliated Obstetrics and Gynecology Hospital Affiliated to Fudan University were enrolled in this retrospective study.Among 184 patients were followed up,the range of following up were 12 to 21 months.116 cases presented dysmenorrheal.Based on postoperative treatment,they were classified into 124 cases treated by domestic gonadotropin releasing hormone agonist (GnRH-a) post-operatively for 3-6 months and 60 cases without postoperative treatment.Among all,63 patients were treated with,that was leuprorelin acetate microspheres for injection (Beiyi,3.75 mg,q28 d),61 patients were treated with imported GnRH-a post-operatively for 3-6 months,that were either Zoladex (3.6 mg,q28 d),Dophereline (3.75 mg,q28 d) or Enatone (3.75 mg,q28 d).The recurrence and pain improvement were compared among those groups.Results (1) The total rate of cyst recurrence was 12.5％ (23/184) while the average recurrent time was (13.7 ±2.6) months (2-21 months).The cyst recurrence rate was significantly lower in patients treated with GnRH-a post-operatively than those who didn't take medications [21.7％ (13/60) versus 8.1％ (10/24),P ＜ 0.05].However,there was no significant difference between domestic GnRH-a group and the imported one [7.9％ (5/63) versus 8.2％ (5/61),P ＞ 0.05].(2) After conservative surgery,symptoms were found to be relieved in 87.1％ (101/116) patients among 116 patients complaining of dysmenorrheal preoperatively and the pain recurrence rate was 12.9％ (13/101).However,there was no significant difference in either symptom relief rate or pain recurrence rate among different groups.The symptom relief rate were 87％ (33/38),86％ (37/43) and 89％ (31/35) while the pain recurrence rate were 12％ (4/33),14％ (5/37) and 13％ (4/31) respectively in none,imported GnRH-a group and domestic GnRH-a group.Conclusions Leuprorelin acetate microspheres could be effective in preventing recurrence of ovarian endometrioma,but not in symptom relieving after conservative surgery in short term.The effect of domestic and imported GnRH-a was similar.
