地诺孕素在子宫腺肌病患者腹腔镜手术后的应用价值OA

Objective:To investigate the clinical value of dienogest after laparoscopic surgery in patients with adenomyosis.Methods:A total of 114 patients with adenomyosis who scheduled to undergo laparoscopic lesion resection at our hospital from October 2022 to June 2024 were prospectively enrolled and allocated by the random number table method to the control group(2 patients voluntarily withdrew from the trial;n=55)or the observation group(1 patient voluntarily withdrew from the trial and 2 patients were excluded because of poor compliance;n=54).The control group received postoperative leuprorelin acetate microspheres for injection,whereas the observation group received postoperative dienogest tablets.Both groups were treated continuously for 3 months and were followed up until 12 months.Changes in the Chinese version of the COX Menstrual Symptom Scale(CMSS)score and Pictorial Blood Loss Assessment Chart(PBAC)score were evaluated.Uterine volume and levels of carbohydrate antigen 125(CA125),8-iso-prostaglandin F2α(PGF2α),vascular endothelial growth factor(VEGF),prostaglandin E2(PGE2),and hemoglobin(Hb)were measured in both groups.Adverse reactions were recorded.Results:After 3 and 12 months of treatment,CMSS score,PBAC score,CA125,VEGF,PGF2α,and PGE2 decreased in both groups(P<0.05),and CMSS score,CA125,VEGF,PGF2α,and PGE2 were lower in the observation group than in the control group(P<0.05).Uterine volume decreased in both groups and was smaller in the observation group than in the control group(P<0.05).Hb increased in both groups(P<0.05),with no significant difference between groups(P>0.05).The incidence of irregular vaginal bleeding was higher in the observation group than in the control group(P<0.05).No significant differences were observed between the two groups in hot flashes and sweating,mood changes,insomnia and irritability,musculoskeletal pain,or the overall incidence of adverse reactions(P>0.05).Conclusion:Dienogest after laparoscopic surgery in patients with adenomyosis is beneficial for relieving dysmenorrhea symptoms and regulating CA125,VEGF,PGF2α,and PGE2 expression,but it may increase the incidence of irregular vaginal bleeding.