醋酸曲普瑞林联合左炔诺孕酮宫内节育器治疗子宫内膜非典型增生

摘要

Objective To explore the feasibility of triptorelin acetate for injection combined with levonorgestrel intrauterine contraception device in the treatment of endometrial atypical hyperplasia (EAH).Methods From October 2014 to June 2017,120 cases of EAH treated at our hospital were randomly divided into an observation group and a control group,60 cases for each group.The control group were treated with triptorelin acetate for injection,and the observation group with triptorelin acetate for injection and levonorgestrel intrauterine contraception device.The observation period was 3 months.The clinical efficacy,the thickness of endometrium,the amount of menstruation (PBAC),the quality of life [sexual quality of life (FSFI score),and the quality of daily life (SF-36 score)] before and after the treatment were compared between the two groups.And the safety of the two groups during the treatment was analyzed.Results The total effective rate of the observation group was 93.33％ (56/60),which was higher than that of the control group [80.00％ (48/60)] (P ＜ 0.05).After the treatment,the endometrial thickness and PBAC score of the two groups were better than those before the treatment (P ＜ 0.05).The endometrial thickness was thinner and the PBAC score was lower in the observation group than in the control group (P ＜ 0.05).During the treatment period,the incidence of adverse reactions was 10.00％ (6/60) in the observation group,and was 8.33％ (5/60) in the control group,with no statistical difference (P ＞ 0.05).After treatment,the FSFI scores and SF-36 scores of the two groups were improved compared with those before treatment (P ＜ 0.05).The FSFI score and SF-36 score were higher in the observation group than in the control group (P ＜ 0.05).Conclusion The efficacy of triptorelin acetate for injection combined with levonorgestrel intrauterine contraception device in the treatment of patients with EAH is significant.It can effectively improve their menstrual abnormality,endometrial thickening,and quality of life and is safe.%目的 探讨注射用醋酸曲普瑞林联合左炔诺孕酮宫内节育器治疗子宫内膜非典型增生(EAH)的可行性.方法 选取2014年10月至2017年6月本院120例EAH患者,按照随机数字表法分为观察组与对照组,各60例.对照组给予注射用醋酸曲普瑞林治疗,观察组在此基础上联合左炔诺孕酮宫内节育器治疗,观察周期为3个月.对比两组临床疗效、治疗前后子宫内膜厚度、月经量(PBAC评分)、生活质量[性生活质量(FSFI评分)及日常生活质量(SF-36评分)],分析两组治疗期间安全性.结果 观察组治疗总有效率高于对照组[93.33％(56/60)比80.00％(48/60),P＜0.05];治疗后,两组子宫内膜厚度及PBAC评分均较治疗前改善(均P＜0.05),且观察组内膜厚度小于对照组,PBAC评分低于对照组(均P＜ 0.05);治疗期间观察组不良反应发生率10.00％ (6/60),对照组8.33％(5/60)差异无统计学意义(P＞0.05);治疗后,两组FSFI评分及SF-36评分均较治疗前提高(均P＜0.05),且观察组FSFI评分及SF-36评分高于对照组(均P＜0.05).结论 注射用醋酸曲普瑞林联合左炔诺孕酮宫内节育器治疗EAH效果显著,可有效改善月经异常及子宫内膜增厚,有利于提高患者生活质量,且安全性有保证.