摘要
目的分析地塞米松联合地诺孕素及亮丙瑞林对子宫内膜异位症不孕患者腹腔镜术后炎症介质、妊娠情况的影响。方法纳入2019年10月—2022年10月在聊城市第二人民医院行腹腔镜手术治疗的子宫内膜异位症不孕患者96例,随机分为治疗组(48例,地塞米松+地诺孕素+亮丙瑞林)、对照组(48例,地诺孕素+亮丙瑞林),比较2组患者血清炎症介质、性激素水平,评估疼痛情况、临床疗效,记录治疗期间肌无力、恶心呕吐、皮疹等不良反应,分别于治疗后6个月、1年进行随访,统计患者复发情况及妊娠情况。结果治疗组治疗后血清白介素6(interleukin 6,IL-6)、前列腺素E2(prostaglandin E2,PGE2)水平低于对照组,差异有统计学意义(P<0.05);治疗组治疗后血清雌二醇(estradiol,E2)、黄体生成素(luteinizing hormone,LH)、卵泡刺激素(follicle stimulating hormone,FSH)、睾酮(testosterone,T)、孕酮(progesterone,P)、催乳激素(prolactin,PRL)水平低于对照组,差异有统计学意义(P<0.05);治疗后1个月、3个月、6个月治疗组疼痛视觉模拟法(visual analogue scale,VAS)评分低于对照组,差异有统计学意义(P<0.05);治疗组肌无力、皮疹等不良反应总发生率与对照组对比,差异无统计学意义(P>0.05);治疗组治疗后1年复发率低于对照组,治疗后6个月、1年自然妊娠成功率高于对照组,差异均具有统计学意义(P均<0.05)。结论子宫内膜异位症不孕患者腹腔镜术后接受地塞米松联合地诺孕素及亮丙瑞林治疗效果显著,可减轻其炎症反应,改善性激素水平,促进患者疼痛症状缓解,且可降低复发风险,提高患者自然妊娠成功率,安全性高。
Objective:To analyze the effect of dexamethasone combined with dienogest and leuprolide in patients with endometriosis infertility after laparoscopic surgery.Methods:A total of 96 patients with endometriosis infertility who underwent laparoscopic surgery in the second People's Hospital of Liaocheng City from October 2019 to October 2022 were chosen and randomly divided into a treatment group(48 cases,dexamethasone+dienogest+leuprolide)and a control group(48 cases,dienogest+leuprolide).The serum inflammatory mediators and sex hormone levels of the two groups were measured and compared,the pain situation and clinical efficacy were evaluated,and the adverse reactions such as muscle weakness,nausea,vomiting,and rash during treatment were recorded.Follow-up visit was performed 6 months and 1 year after treatment,and the recurrence and pregnancy status of the patients were counted.Results:After treatment,the levels of serum interleukin(IL-6)and prostaglandin E2(PGE2)in the treatment group were lower than those in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of serum estradiol(E2),luteinizing hormone(LH),follicle stimulating hormone(FSH),testosterone(T),progesterone(P),and prolactin(PRL)in the treatment group were lower than those in the control group,and the difference was statistically significant(P<0.05).The visual analogue test(VAS)of the treatment group was significantly higher than that of the control group at 1 month,3 months,and 6 months after treatment.VAS score was significantly higher than that of the control group(P<0.05);the total incidence of adverse reactions such as myasthenia and rash in the treatment group was not statistically significant compared with that in the control group(P>0.05);the recurrence rate in the treatment group was lower than that in the control group one year after treatment,and the natural pregnancy success rate was higher than that in the control group 6 months and one year after treatment,with statistically significant differences(P<0.05).Conclusion:The treatment of infertile patients with endometriosis after laparoscopic surgery with dexamethasone combined with dienogest and leuprorelin has significant effects,can reduce the inflammatory response,improve the level of sex hormones,promote the relief of patients'pain symptoms,reduce the risk of recurrence,and improve the success rate of natural pregnancy in patients with high safety.
作者
周瑾
王涛
ZHOU Jin;WANG Tao(Department of Reproductive Endocrinology,The Second People's Hospital of Liaocheng City,liaocheng 252600,China)
出处
《山东第一医科大学（山东省医学科学院）学报》
CAS
2024年第11期673-677,共5页
Journal of Shandong First Medical University ＆ Shandong Academy of Medical Sciences
关键词
子宫内膜异位症
雌二醇
炎症介质
地塞米松
卵泡刺激素
endometriosis
estradiol
inflammatory mediators
dexamethasone
follicle-stimulating hormone
