子宫内膜异位症切除术后激素替代治疗疗效分析

目的探讨激素替代治疗Ⅲ-Ⅳ期子宫内膜异位症切除术后(全子宫及双侧附件切除术后)的临床疗效与安全性.方法2002年1月至2005年1月将40例患者,随机分成两组,(各20例):观察组口服倍美力0.3-0.625mg,每日1次.对照组口服利维爱1.25mg,每日或隔日1次.治疗前后检查盆腔情况,肝肾功能,体内血清FSH(卵泡刺激素)血清E2(雌二醇)水平,记录治疗期间盆腔痛,性交痛等子宫内膜异位症相关症状和乳房胀痛等不良反应,Kupperman评分(K评分)每月1次.结果两组用药后围绝经期症状均明显改善,无子宫内膜异位症复发表现,血浆E2水平上升,治疗前后比较差异有显著性意义(P＜0.01).治疗后E2水平观察组高于对照组,两组比较差异有显著性意义(P＜0.01),但均在安全范围内.结论小剂量倍美力和利维爱用于Ⅲ-Ⅳ期子宫内膜异位症切除术后患者,均能安全,有效地控制围绝经期症状.

The effects and Safety of hormone replacement therapy on women with endometriosis and underwent hysterectomy and bilateral Salpingo-oophorectomy

Objective To estimate the recurrence of endometriosis and clinical effects after administration of hormone replacement therapy(HRT)among women who have had endometriosis and underwent hysterectomy and bilateral salpingo-oophorectomy(BSO). Methods 40 patients were divided into two groupes randomly. 20 received livial 1.25mg every other day or every day orally- and 20 received Conjugated Estrogens 0.3-0.625mg every day orally. Periodical clinical examination-vaginal ultrasound-radiographic examination of breast were performed-and the level of E2?FSH and the symptoms of endometriosis were recorded. Kupperman score were observed before and after treatment between two groups. Results After treatment-there was no recurrence in two groups. The symptoms of perimenopause were significantly improved in both groups(P<0.01)-and the level of E2 significantly increased in two groups(P<0.01). The group who received estradiol valerate had higher level of E2 than the group who received livial(P<0.05). Conclusions The low dose Conjugated Estrogens and livial can relieve climacteric symptoms safely on women who have had endometriosis and underwent hysterectomy and bilateral salpingo-oophorectomy.