生殖医学杂志2025，Vol.34Issue(11)：1474-1479,6.DOI:10.3969/j.issn.1004-3845.2025.11.004
Ⅰ～Ⅲ期卵巢型及腹膜型子宫内膜异位症术后预防复发方案探讨
Discussion on the postoperative recurrence prevention schemes for stage Ⅰ-Ⅲ ovarian and peritoneal endometriosis
摘要
Abstract
Objectives:To explore the postoperative prevention strategies for recurrence of stage Ⅰ-Ⅲ ovarian and peritoneal endometriosis(EMs),aiming to provide a reference for the selection of postoperative drug treatment for patients. Methods:A retrospective study was conducted to analyze the clinical data of 80 inpatients with stage Ⅰ-Ⅲ ovarian and peritoneal EMs and without immediate fertility needs after surgery in Women and Children's Hospital of Qingdao University from June 2020 to April 2024.The patients were divided into the study group(n=42)and the control group(n=38)based on different postoperative medication regimens.Patients in the study group underwent levonorgestrel intrauterine system(LNG-IUS)insertion after the operation,while those in the control group received short-acting contraceptive pill of Drospirenone and Ethinylestradiol Tablets(Ⅱ)after the operation.The dysmenorrhea,pain during sexual intercourse,pelvic pain visual analogue scale(VAS)scores,serum carbohydrate antigen 125(CA125)level,postoperative recurrence rate and adverse reactions occurrence were compared between the two groups. Results:There were no significant differences in general characteristics between the two groups(P＞0.05).The VAS scores for dysmenorrhea,sexual pain and pelvic pain at 3,6 and 12 months after surgery in the study group were all significantly lower than those in the control group(all P＜0.05).The serum CA125 levels at 6 months[(30.08±6.37)U/ml vs.(36.25±6.82)U/ml,P＜0.05]and 12 months[(21.26±5.98)U/ml vs.(25.37±6.18)U/ml,P＜0.05]after surgery in the study group were significantly lower than those in the control group.The total effective rate of treatment in the study group at 12 months after surgery was significantly higher than that in the control group(92.86％vs.76.32％,P＜0.05).The total recurrence rate at 12 months after surgery in the study group was significantly lower than that in the control group(7.14％vs.23.68％,P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(11.90％vs.15.79％,P＞0.05). Conclusions:Compared with oral contraceptives,the insertion of LNG-IUS after surgery for stage Ⅰ-Ⅲ ovarian and peritoneal EMs can enhance clinical efficacy,alleviate pain symptoms,reduce the recurrence rate after surgery,and improve the prognosis of patients.关键词
卵巢型子宫内膜异位症/子宫内膜异位症/左炔诺孕酮宫内节育系统/避孕药/复发率Key words
Ovarian endometriosis/Endometriosis/Levonorgestrel intrauterine system/Contraceptive/Recurrence rate分类
医药卫生引用本文复制引用
李楠楠,王瑞,杨贵霞,胡友斌..Ⅰ～Ⅲ期卵巢型及腹膜型子宫内膜异位症术后预防复发方案探讨[J].生殖医学杂志,2025,34(11):1474-1479,6.基金项目
青岛市民生科技计划项目(17-3-3-23-nsh) （17-3-3-23-nsh）
山东省医药卫生科技项目(202405011318) （202405011318）
