青少年疼痛性子宫内膜异位症的管理：法国国家妇产科与妇科学会-法国健康高级管理局子宫内膜异位症指南
[Management of painful endometriosis in adolescents: CNGOF-HAS Endometriosis Guidelines].
作者信息
Sauvan M, Chabbert-Buffet N, Geoffron S, Legendre G, Wattier J-M, Fernandez H
机构信息
Service de gynécologie-obstétrique, CHU de Bicêtre, AP-HP, 78, avenue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France.
Service de gynécologie-obstétrique et médecine de la reproduction, CHU de Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; GRC-6 Centre expert en endométriose (C3E), Sorbonne université, 75005 Paris, France; UMR-S938 Inserm Sorbonne université, 75005 Paris, France.
出版信息
Gynecol Obstet Fertil Senol. 2018 Mar;46(3):264-266. doi: 10.1016/j.gofs.2018.02.029. Epub 2018 Mar 5.
OBJECTIVE
To analyse the literature on the treatment of adolescent painful endometriosis.
METHOD
This work is based on a Review of the literature between January 2006 and December 2017. The Medline (Pubmed) and Cochrane database were searched for meta-analyzes, randomized trials, literature reviews, controlled, not controlled and retrospective studies published on the subject. Studies concerning adolescent's dysmenorrhea without endometriosis were excluded.
RESULTS
Study quality is heterogeneous. Dienogest and GnRH agonists (GnRHa) are the only treatments specifically evaluated for the treatment of adolescent endometriosis. They reduce the pain associated with endometriosis. Combined oral contraceptives have not been studied in the context of endometriosis but they are effective on dysmenorrhea. Add back therapy, containing estrogens improves bone mineral density and quality of life for young women treated with GnRHa.
CONCLUSION
Medical treatment of endometriosis in adolescent is associated with risks related to the young age. The therapeutic strategy should take into account the adverse effects of each treatment.
目的
分析有关青少年疼痛性子宫内膜异位症治疗的文献。
方法
本研究基于对2006年1月至2017年12月间文献的综述。检索了Medline（Pubmed）和Cochrane数据库，以查找关于该主题发表的荟萃分析、随机试验、文献综述、对照、非对照和回顾性研究。排除了有关无子宫内膜异位症的青少年痛经的研究。
结果
研究质量参差不齐。地诺孕素和促性腺激素释放激素激动剂（GnRHa）是仅有的专门针对青少年子宫内膜异位症治疗进行评估的药物。它们可减轻与子宫内膜异位症相关的疼痛。复方口服避孕药尚未在子宫内膜异位症的背景下进行研究，但它们对痛经有效。含雌激素的反向添加疗法可改善接受GnRHa治疗的年轻女性的骨密度和生活质量。
结论
青少年子宫内膜异位症的药物治疗与年龄相关的风险有关。治疗策略应考虑每种治疗的不良反应。
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