Adachi Kazushige, Takahashi Kayo, Nakamura Koji, Otake Akiko, Sasamoto Naoko, Miyoshi Yukari, Shioji Mitsunori, Yamamoto Yoshimitsu, Fujitani Mayumi, Wakimoto Akinori, Tokuhira Atsushi, Kobayashi Eiji, Yoshimura Akihiko, Sawada Kenjiro, Kimura Tadashi
a Department of Obstetrics and Gynecology , Minoh City Hospital , Osaka , Japan.
b Department of Obstetrics and Gynecology , Osaka University Graduate School of Medicine , Osaka , Japan , and.
Gynecol Endocrinol. 2016 Aug;32(8):646-649. doi: 10.3109/09513590.2016.1147547. Epub 2016 Feb 18.
To assess the effect of dienogest on recurrence of ovarian endometriomas and severity of pain after laparoscopic surgery, a retrospective study of 81 patients was performed at three institutions in Osaka, Japan. Patients had a six-month minimum follow-up after laparoscopic surgery for ovarian endometriomas performed between June 2012 and August 2014. Patients who chose to receive 2 mg dienogest daily and those who were managed expectantly postoperatively were included. Recurrence was defined as the presence of endometriomas of more than 2 cm. A visual analog scale (VAS) was used to score the intensity of pelvic pain. The cumulative recurrence rate and absolute VAS score changes between the baseline and at 6, 12, 18 and 24 months after the start of administration were evaluated in both groups. The recurrence rate was 16.5% and 24.0% in the expectant management group at 12 and 24 months, respectively. No recurrences occurred in the dienogest treatment group. The rate of VAS score reduction was significantly higher in the dienogest than in the expectant management group. Dienogest is effective on the recurrence of ovarian endometrioma and relieving pelvic pain after laparoscopic surgery.
为评估地诺孕素对腹腔镜手术后卵巢子宫内膜异位囊肿复发及疼痛严重程度的影响,在日本大阪的三家机构对81例患者进行了一项回顾性研究。这些患者在2012年6月至2014年8月期间接受了腹腔镜卵巢子宫内膜异位囊肿手术,术后至少随访6个月。纳入了选择每日服用2mg地诺孕素的患者以及术后进行期待治疗的患者。复发定义为存在直径大于2cm的子宫内膜异位囊肿。采用视觉模拟评分法(VAS)对盆腔疼痛强度进行评分。评估了两组患者给药开始时基线与给药后6、12、18和24个月时的累积复发率以及VAS绝对评分变化。期待治疗组在12个月和24个月时的复发率分别为16.5%和24.0%。地诺孕素治疗组未发生复发。地诺孕素组的VAS评分降低率显著高于期待治疗组。地诺孕素对腹腔镜手术后卵巢子宫内膜异位囊肿的复发有效,并能缓解盆腔疼痛。