腹腔镜下卵巢巧克力囊肿剥除术后辅以不同药物治疗的疗效比较

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目的比较卵巢巧克力囊肿剥除术后辅以达菲林、孕三烯酮、米非司酮治疗卵巢巧克力囊肿的临床效果。方法收集2012年3月-2015年6月于该院妇科治疗的120例卵巢巧克力囊肿患者为研究对象,随机分为A、B、C 3组,每组各40例。术后1周,A组患者开始肌注达菲林3.75 mg,之后每隔28 d肌注1次,连用3个月;B组患者开始口服孕三烯酮2.5 mg/次,2次/周,连服3个月;C组患者开始口服米非司酮10 mg/d,连服3个月。比较3组患者血清性激素水平和疗效。结果治疗前3组患者的卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_2)、孕酮(P)水平比较差异均无统计学意义(F值分别为0.221、1.712、0.552和0.971,均P>0.05);治疗后,3组患者的FSH、LH、E_2、P水平较本组治疗前差异均有统计学意义(t值分别为33.87、27.71、26.12;8.29、7.97、8.03;2.91、3.77、4.15;6.20、5.72、5.37,P<0.05或P<0.01)。治疗后,A组的E2水平相较于B组和C组差异有统计学意义(F=8.408,P<0.05)。3组总有效率差异均没有统计学意义(χ~2值分别为1.802、3.818和0.409,均P>0.05)。A组的复发率明显低于C组,差异有统计学意义(χ~2=4.105,P<0.05),但是B组复发率分别与A组、C组比较差异均没有统计学意义(χ~2值分别为0.542、1.802,均P>0.05)。结论腹腔镜剥除卵巢巧克力囊肿术后联合达菲林、孕三烯酮或米非司酮治疗,均能够抑制残余病灶复发,对预防卵巢巧克力囊肿复发具有良好的治疗效果,但达菲林的复发率显著低于孕三烯酮和米非司酮。 Objective To compare the clinical effects of ovarian chocolate cyst treated with daphnilin, gestrinone and mifepristone after ovariectomy. Methods A total of 120 patients with ovarian chocolate cyst treated in our hospital from March 2012 to June 2015 were randomly divided into A, B and C groups, 40 cases in each group. One week after operation, patients in group A started intramuscular injection of 3.75 mg of film, and intramuscularly injected once every 28 days for 3 months. Patients in group B started oral administration of gestrinone 2.5 mg twice daily, Even for 3 months; C group began oral mifepristone 10 mg / d, and even for 3 months. Serum sex hormone levels and efficacy were compared between the three groups. Results There was no significant difference in the levels of FSH, LH, E2 and progesterone between the three groups before treatment (F = 0.221, 0.552 and 0.971, all P> 0.05). After treatment, the levels of FSH, LH, E_2, P in three groups were significantly different from those before treatment (t = 33.87,27.71,26.12,2.29,7.97 , 8.03; 2.91, 3.77, 4.15; 6.20, 5.72, 5.37, P <0.05 or P <0.01). After treatment, the level of E2 in group A was significantly lower than that in group B and C (F = 8.408, P <0.05). There was no significant difference in the total effective rate between the three groups (χ ~ 2 = 1.802, 3.818 and 0.409, all P> 0.05). The recurrence rate of group A was significantly lower than that of group C (χ ~ 2 = 4.105, P <0.05), but there was no significant difference between group A and group C (χ ~ 2 values ​​were 0.542,1.802, all P> 0.05). Conclusion laparoscopic ovarian chocolate cyst surgery combined with dalfarin, gestrinone or mifepristone treatment can inhibit the recurrence of residual lesions on the prevention of ovarian chocolate cyst recurrence has a good therapeutic effect, but the recurrence rates of daphnilin Significantly lower than gestrinone and mifepristone.
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