摘要
目的探讨促性腺激素释放激素类似物(GnRH-a)联合反向添加治疗子宫内膜异位症(endometrisis, EMT)术后临床效果。方法选取术后EMT 60例,根据不同治疗方法将其分为观察组与对照组两组各30例,观察组采用GnRH-a联合反向添加进行治疗,对照组采用GnRH-a进行治疗。比较两组治疗后临床效果、治疗前后血浆性激素水平、治疗前后骨代谢生化指标及腰椎骨密度(L-BMD)水平、治疗前后Kupperman评分与疼痛视觉模拟评分法(visual analogue scale, VAS)评分以及治疗过程中不良反应发生情况。结果治疗后,观察组总有效率为90.00%明显高于对照组总有效率66.67%,差异具有统计学意义(P<0.05)。治疗前,两组血浆雌二醇(E_2)、促黄体生成激素(LH)、卵泡刺激素(FSH),血钙、血磷、碱性磷酸酶、L-BMD水平及Kupperman评分、VAS评分比较差异无统计学意义(P>0.05)。治疗后,两组血浆E_2、FSH、LH水平及VAS评分均较治疗前降低,Kupperman评分均较治疗前升高;观察组血钙、血磷及碱性磷酸酶较治疗前升高,差异有统计学意义(P<0.05)。治疗后,观察组血浆E_2、FSH及血钙、血磷、碱性磷酸酶水平高于对照组,Kupperman评分低于对照组,差异有统计学意义(P<0.05)。治疗过程中,观察组不良反应总发生率为13.33%明显低于对照组不良反应总发生率36.67%,差异具有统计学意义(P<0.05)。结论与单独应用GnRH-a相比,GnRH-a联合反向添加可提高EMT患者术后临床治疗效果,并通过维持机体雌激素稳定,减少钙磷流失,进而改善患者预后,且具有较高安全性。
ObjectiveTo explore the clinical effect of gonadotropin releasing hormone analogs (GnRHa) and reverse addition therapy in the treatment of endometriosis (EMT). MethodsSixty patients with EMT admitted to our hospital from June 2017 to December 2018 were divided into control group (n=30) and observation group (n= 30) according to different treatment methods. The control group was treated with GnRHa, while the observation group was supplemented with reverse addition therapy on the basis of the control group. Clinical effect after treatment was compared in both groups. In addition, serum sex hormone levels, biochemical markers of bone metabolism, lumbar spine bone mineral density (L-BMD), Kupperman score, visual analogue scale (VAS) score, and adverse reactions were analyzed before and after treatment. ResultsThe total effective rate of the observation group was 90.00%, which was significantly higher than that of the control group (66.67%), and there was a significant difference ( P <0.05). There were no significant differences in plasma estradiol (E 2), luteinizing hormone (LH), follicle stimulating hormone (FSH), serum calcium, serum phosphorus, alkaline phosphatase, L-BMD levels, Kupperman score, and VAS score before treatment ( P >0.05). The levels of E 2, FSH and LH, as well as VAS score in the two groups were significantly lower after treatment, while Kupperman score was increased as compared with that before treatment. Serum calcium, serum phosphorus, and alkaline phosphatase were higher after treatment in observation group, suggesting significant differences ( P <0.05). After treatment, levels of E 2, FSH, serum calcium, serum phosphorus and alkaline phosphatase in observation group were significantly higher than those in control group, while Kupperman score was lower than that in control group, indicating significant differences ( P <0.05). The total incidence of adverse reactions in the observation group was 13.33%, which was significantly lower than that in the control group (36.67%, P <0.05). ConclusionCompared with GnRHa alone, GnRHa combined with reverse addition therapy can improve the clinical efficacy of EMT patients after operation. It has high safety by maintaining the stability of estrogen and reducing the loss of calcium and phosphorus, thereby improving the prognosis of EMT patients.
作者
张斯斯
金海红
王智文
姜丽
孟津
陈红娟
ZHANG Si-si;JIN Hai-hong;WANG Zhi-wen;JIANG Li;MENG Jin;CHEN Hong-juan(Department of Gynecology, the First Hospital of Qinhuangdao City, Qinhuangdao, Hebei 066000, China)
出处
《临床误诊误治》
2019年第5期49-53,共5页
Clinical Misdiagnosis & Mistherapy
基金
河北省科学技术厅科技支撑项目(20181801)
秦皇岛市科学技术研究与发展项目(201703A096)
