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目的 探讨激素替代治疗Ⅲ～Ⅳ期子宫内膜异位症根治术后 (全子宫及双侧附件切除术后 )的临床疗效与安全性。方法 2 0 0 1年 3月至 2 0 0 2年 12月将 30例患者随机分成两组 (各 15例 ) :观察组口服戊酸雌二醇0 5～ 1 0mg ,每日 1次。对照组口服利维爱 1 2 5mg ,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 0 1)。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 0 1) ,但均在安全范围内。结论 小剂量戊酸雌二醇和利维爱用于Ⅲ～Ⅳ期子宫内膜异位症根治术后患者 ,均能安全、有效地控制围绝经期症状。
Objective To investigate the clinical efficacy and safety of hormone replacement therapy after stage Ⅲ ~ Ⅳ endometriosis (total hysterectomy and bilateral attachment resection). Methods From March 2001 to December 2002, 30 patients were randomly divided into two groups (15 in each). The observation group was orally administered with estradiol valerate from 0 to 100 mg once daily. The control group oral Levi love 1 2 5mg, daily or every other day. Pelvic conditions, liver and kidney function, serum FSH (FSH) and E2 (estradiol) levels were recorded before and after treatment. The symptoms related to endometriosis, such as pelvic pain and pain during sexual intercourse, and breast tenderness were recorded Adverse reactions, Kupperman score (K score) once a month. Results The symptoms of perimenopausal women in both groups were significantly improved after treatment. There was no recurrence of endometriosis and the level of plasma E2 increased. There was significant difference between before and after treatment (P <0.01). After treatment, the level of E2 in the observation group was higher than that of the control group, with significant difference between the two groups (P <0.01), but both were in the safe range. Conclusions Small doses of estradiol valerate and levofloxacin can effectively and effectively control perimenopausal symptoms in patients with stage III-IV endometriosis.