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传统的治疗原发性痛经的药物如口服避孕药及非甾体类消炎药能缓解多数患者的痛经程度,但仍有部分患者对药物治疗无反应。日益增多的研究证据表明,可以采用神经切断术用于药物治疗无效的顽固性痛经。有限的临床证据显示,腹腔镜下子宫神经消融术能够改善原发性痛经患者痛经症状,但其疗效可能逐渐消退;而腹腔镜下骶前神经切断术能更有效地缓解药物治疗无效的原发性痛经患者的痛经症状,但其并发症如便秘的发生率较高。总之,目前尚缺乏高质量的随机对照试验及循证医学证据予以证实。
The traditional treatment of primary dysmenorrhea drugs such as oral contraceptives and non-steroidal anti-inflammatory drugs can ease the majority of patients with dysmenorrhea, but still some patients did not respond to drug treatment. Increasing research evidence suggests that neurotomization may be used for refractory dysmenorrhea with ineffective drug treatment. Limited clinical evidence shows that laparoscopic uterine nerve ablation can improve dysmenorrhea symptoms in patients with primary dysmenorrhea, but its efficacy may subside; and laparoscopic presacral neurotomy can more effectively relieve the ineffective primary drug treatment Dysmenorrhea in patients with dysmenorrhea symptoms, but its complications such as the incidence of constipation is higher. In conclusion, there is a lack of high-quality randomized controlled trials and evidence-based medical evidence to confirm.