【摘要】 目的 探讨左炔诺孕酮宫内释放系统联合桂枝茯苓胶囊治疗子宫腺肌病的疗效。 方法 2006年2月-2010年2月108例子宫腺肌病患者随机分为观察组（n=56）与对照组（n=52），观察组患者宫内放置左炔诺孕酮宫内释放系统，同时口服中成药桂枝茯苓胶囊，3粒/次，3次/d，连服6个月。对照组单放置左炔诺孕酮宫内释放系统进行治疗，观察月经量、痛经程度、子宫体积及血清CA125水平变化。 结果 6个月后，观察组患者痛经明显缓解，月经量显著减少，子宫体积缩小，血清CA125水平明显降低，治疗前后比较，差异均有统计学意义（Plt;0.05）；与对照组比较，痛经评级、子宫体积缩小、血清CA125水平差异均有统计学意义（Plt;0.05）。 结论 左炔诺孕酮宫内释放系统与桂枝茯苓胶囊联合治疗子宫腺肌病安全有效，满意度高，值得临床推广应用。【Abstract】 Objective To evaluate the therapeutic effect of levonorgestrel-releasing intrauterine system (LNG-IUS) combined with Guizhi Fulin capsules treating adenomyosis. Methods A total of 108 patients with adenomyosis diagnosed in our hospital from February 2006 to February 2010 were randomly divided into the observation group (n=56) and the control group (n=52). The patients in the observation group were treated with LNG-IUS and simultaneously administrated orally with the Guizhi Fulin capsules (three capsules per time, three times per day for six continuous months). The patients in the control group were treated with LNG -IUS only. The changes of the menstrual blood volume, severity of dysmenorrhea, uterine volume and the level of serum CA125 were observed and evaluated. Results After six months’ treatment, dysmenorrhea of all the patients was obviously alleviated, the menstrual blood volume reduced significantly, the uterine volume shrank, and the level of serum CA125 decreased significantly; the results after the treatment differed much from that before the treatment (Plt;0.05). Compared with those in the control group, the differences in the grades of the dysmenorrheal, shrinkage of the uterine volume and the level of serum CA125 were statistically significant (Plt;0.05). Conclusion Combined usage of LNG-IUS and Guizhi Fulin capsules is an effective and safe way treating adenomyosis.
【摘要】 目的 探讨各种不同体外受精（IVF）助孕方案对子宫腺肌病伴不孕症患者的疗效。 方法 对2006年1月-2009年6月进行IVF助孕治疗的子宫腺肌病伴不孕症患者63例的临床资料进行回顾性分析。根据是否应用长效促性腺激素释放激素激动剂（GnRH-a）及启动促性腺激素（Gn）时间分为超长方案、长效GnRH-a后长或短方案、常规长方案3组，对IVF助孕疗效进行分析。 结果 3种治疗方案的Gn刺激天数、Gn总量、获卵数、不良反应发生率和流产率比较无统计学意义（Pgt;0.05）；3种治疗方案的周期取消率为20.0%、7.7%、30.0%，比较有统计学意义（χ2=5.74，Plt;0.05），方案2的周期取消率低于方案1和方案3，有统计学意义（χ2=7.21，Plt;0.05）；3种治疗方案的继续妊娠率为23.0%、37.0%、15.3%，有统计学意义（χ2=11.31，Plt;0.05），方案2的继续妊娠率高于方案1和方案3，有统计学意义（χ2=8.52，Plt;0.05）。 结论 与超长方案和常规长方案相比，子宫腺肌病伴不孕症患者采用长效GnRH-a治疗后长方案或短方案行IVF助孕治疗，妊娠率升高，周期取消率降低。【Abstract】 Objective To investigate the effect of different in vitro fertilization (IVF) treatment protocols on infertile women with adenomyosis. Methods Sixty-four infertile women with adenomyosis who had IVF treatment cycles from January 2006 to June 2009 were retrospectively analyzed. According to administration of long course gonadotropin-releasing hormone agonist (GnRH-a) and the start time of gonadotropin (Gn), all participants were divided into three groups: the first group with ultra-long term protocol, the second group with long or short term protocol after administration of long course GnRH-a and the third group with routine long term protocol. Results There were no differences among the three groups with regard to days of Gn administration, amounts of Gn administration, numbers of retrieved oocytes, prevalence of poor response and miscarriage (Pgt;0.05). The cancelation rates of the three groups were 20.0%、7.7% and 30.0% respectively. There were significant differences in cancelation rates among the groups (χ2=5.74, Plt;0.05), and the cancelation rate in the second group was significantly lower than the other groups (χ2=7.21, Plt;0.05). The ongoing pregnancy rates of the groups were 23.0%、37.0% and 15.3% respectively. There were significant differences in ongoing pregnancy rates among three groups (χ2=11.31, Plt;0.05), and the ongoing pregnancy rate in the second group was significantly higher than the other groups (χ2=8.52, Plt;0.05). Conclusion Compared with the ultra-long term and routine long term protocol of IVF treatment in infertile woman with adenomyosis, the ongoing pregnancy rate might be higher and the cancelation rate might be lower in the long or short term protocol after administration of long course GnRH-a.
ObjectiveTo explore the clinical effect and safety of laparoscopic cytoreductive surgery combined with gestrinone in the treatment of adenomyosis. MethodsWe retrospectively analyzed the clinical data of 82 patients with adenomyosis who accepted treatment in our hospital from January 2008 to April 2011. According to different treatment method, the patients were divided into three groups. Twenty-seven patients in the treatment group underwent laparoscopic cytoreductive surgery combined with postoperative treatment with gestrinone. For the 25 patients in the surgery group, only laparoscopic cytoreductive surgery was performed, and 30 other patients who only received oral gestrinone were designated as the medicine group. Dysmenorrhea, menstrual volume, uterine size, serum carcinoembryonic antigen 125 (CA125), anemia, and drug side effects were respectively recorded before and after surgery. ResultsThe dysmenorrhea degree reduced significantly in all the three groups. There was no significant difference in the degree of dysmenorrhea, menstrual volume, and uterine volume between the treatment group and the surgery group (P>0.05); the dysmenorrhea degree was significantly different between the treatment group and the medicine group (P<0.05); the differences in hemoglobin levels and the serum CA125 level between the treatment group and the surgery group 12 months later were significant (P=0.019, P=0.049). ConclusionThe laparoscopic cytoreductive surgery combined with gestrinone in treating adenomyosis can improve recent curative effect and provide more effective symptom control compared with surgery alone.
Objective To analyze the crucial factors which affect the hospitalization expenses of patients with uterine adenomyosis, in order to take corresponding measures. Methods A total of 583 patients diagnosed with uterine fibroids reported by hospitals in urban areas of Suining city through hospital quality monitoring system between December 2013 and December 2015 were included in this study. The main reasons for the expense structure was described by Pareto’s law. The importance of hospitalization expense influencing factors was analyzed by neural network model, and single factor analysis was used to analyze important influencing factors of hospitalization expenses. Results The main factors influencing hospitalization expenses included length of stay in hospital, operation techniques and illness conditions, and their importance value was respectively 0.581, 0.175 and 0.088. Conclusion Based on hospitalization expenses, length of stay in hospital and expense structure, high intensity focused ultrasound therapy is more reasonable in the treatment of uterine adenomyosis.