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Fertil Steril:术后长期服用避孕药或孕激素是预防子宫内膜异位症术后复发的有效手段

2015-10-18 candy 译 MedSci原创

    虽然手术切除子宫内膜异位症既改善疼痛,提高生育能力,复发可以进一步加剧疼痛和降低生育能力,这反过来又影响生活质量和增加个人和社会成本的。因此,防止术后复发是至关重要的。本文回顾了自20世纪90年代以来,预防子宫内膜异位症术后复发的证据。在过去的5年中,许多新的研究已经进行并表明,长期的术后药物治疗显著降低复发率。这些研究大多用循环或连续的治疗方案使用口服避孕药

虽然手术切除子宫内膜异位症可以改善疼痛,提高生育能力,但是其复发可以进一步加剧疼痛和降低生育能力,这反过来又影响生活质量和增加个人和社会成本的。因此,防止术后复发是至关重要的。本文回顾了自20世纪90年代以来,预防子宫内膜异位症术后复发的证据。


在过去的5年中,许多新的研究已经进行并表明,长期的术后药物治疗显著降低复发率。这些研究大多用循环或连续的治疗方案使用口服避孕药(OC),而一些使用口服或宫内孕激素。连续性口服避孕药比循环性使用更有效,特别是对痛经。左炔诺孕酮宫内缓释系统也能防止痛经和子宫内膜异位症病灶复发。地屈孕酮作为一种新的黄体激素,显示能够减少子宫内膜异位症的复发。与卵巢子宫内膜异位症一样,长期的术后用药对于深部浸润或外生殖器的子宫内膜异位症非常重要,虽然数据是有限的。不管病变和药物类型,患者停用药物经历了更高的复发率;因此,表面上看,这些药物的保护作用似乎在停药后迅速消失。

在这些事实的基础上,结合复发的病因(逆行月经和排卵),定期和持续用药直到患者有希望怀孕,是被高度推荐的预防子宫术后复发的方法。

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    2015-10-20 zhouxue1990

    抓住西瓜,丢芝麻

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1708321, encodeId=ae541e0832122, content=<a href='/topic/show?id=4c2d3051535' target=_blank style='color:#2F92EE;'>#内膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30515, encryptionId=4c2d3051535, topicName=内膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=730431558473, createdName=12498974m61暂无昵称, createdTime=Mon Dec 28 10:26:00 CST 2015, time=2015-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1665601, encodeId=c568166560169, content=<a href='/topic/show?id=685445152f6' target=_blank style='color:#2F92EE;'>#子宫内膜异位#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45152, encryptionId=685445152f6, topicName=子宫内膜异位)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4de125981980, createdName=12498f17m74暂无昵称, createdTime=Mon Feb 15 03:26:00 CST 2016, time=2016-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1991805, encodeId=9a6a19918052e, content=<a href='/topic/show?id=ea25610484f' target=_blank style='color:#2F92EE;'>#术后复发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61048, encryptionId=ea25610484f, topicName=术后复发)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=62e4433, createdName=zz12341234, createdTime=Sun Dec 13 14:26:00 CST 2015, time=2015-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=40000, encodeId=df75400009e, content=抓住西瓜,丢芝麻, beContent=null, objectType=article, channel=null, level=null, likeNumber=145, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a1a01625167, createdName=zhouxue1990, createdTime=Tue Oct 20 22:45:00 CST 2015, time=2015-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385344, encodeId=277b13853448e, content=<a href='/topic/show?id=9aeb45318ed' target=_blank style='color:#2F92EE;'>#孕激素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45318, encryptionId=9aeb45318ed, topicName=孕激素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=05a2499, createdName=dzx0922889, createdTime=Tue Oct 20 13:26:00 CST 2015, time=2015-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39493, encodeId=2835394934f, content=为了积分我也是拼了~, beContent=null, objectType=article, channel=null, level=null, likeNumber=138, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 12:03:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39491, encodeId=b9f73949128, content=感谢分享~, beContent=null, objectType=article, channel=null, level=null, likeNumber=156, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 12:02:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39492, encodeId=3cc439492b9, content=赞一个~, beContent=null, objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 12:02:00 CST 2015, time=2015-10-19, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1708321, encodeId=ae541e0832122, content=<a href='/topic/show?id=4c2d3051535' target=_blank style='color:#2F92EE;'>#内膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30515, encryptionId=4c2d3051535, topicName=内膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=730431558473, createdName=12498974m61暂无昵称, createdTime=Mon Dec 28 10:26:00 CST 2015, time=2015-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1665601, encodeId=c568166560169, content=<a href='/topic/show?id=685445152f6' target=_blank style='color:#2F92EE;'>#子宫内膜异位#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45152, encryptionId=685445152f6, topicName=子宫内膜异位)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4de125981980, createdName=12498f17m74暂无昵称, createdTime=Mon Feb 15 03:26:00 CST 2016, time=2016-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1991805, encodeId=9a6a19918052e, content=<a href='/topic/show?id=ea25610484f' target=_blank style='color:#2F92EE;'>#术后复发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61048, encryptionId=ea25610484f, topicName=术后复发)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=62e4433, createdName=zz12341234, createdTime=Sun Dec 13 14:26:00 CST 2015, time=2015-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=40000, encodeId=df75400009e, content=抓住西瓜,丢芝麻, beContent=null, objectType=article, channel=null, level=null, likeNumber=145, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a1a01625167, createdName=zhouxue1990, createdTime=Tue Oct 20 22:45:00 CST 2015, time=2015-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385344, encodeId=277b13853448e, content=<a href='/topic/show?id=9aeb45318ed' target=_blank style='color:#2F92EE;'>#孕激素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45318, encryptionId=9aeb45318ed, topicName=孕激素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=05a2499, createdName=dzx0922889, createdTime=Tue Oct 20 13:26:00 CST 2015, time=2015-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39493, encodeId=2835394934f, content=为了积分我也是拼了~, beContent=null, objectType=article, channel=null, level=null, likeNumber=138, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 12:03:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39491, encodeId=b9f73949128, content=感谢分享~, beContent=null, objectType=article, channel=null, level=null, likeNumber=156, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 12:02:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39492, encodeId=3cc439492b9, content=赞一个~, beContent=null, objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 12:02:00 CST 2015, time=2015-10-19, status=1, ipAttribution=)]
    2015-10-19 sunlong28

    为了积分我也是拼了~

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1708321, encodeId=ae541e0832122, content=<a href='/topic/show?id=4c2d3051535' target=_blank style='color:#2F92EE;'>#内膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30515, encryptionId=4c2d3051535, topicName=内膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=730431558473, createdName=12498974m61暂无昵称, createdTime=Mon Dec 28 10:26:00 CST 2015, time=2015-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1665601, encodeId=c568166560169, content=<a href='/topic/show?id=685445152f6' target=_blank style='color:#2F92EE;'>#子宫内膜异位#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45152, encryptionId=685445152f6, topicName=子宫内膜异位)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4de125981980, createdName=12498f17m74暂无昵称, createdTime=Mon Feb 15 03:26:00 CST 2016, time=2016-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1991805, encodeId=9a6a19918052e, content=<a href='/topic/show?id=ea25610484f' target=_blank style='color:#2F92EE;'>#术后复发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61048, encryptionId=ea25610484f, topicName=术后复发)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=62e4433, createdName=zz12341234, createdTime=Sun Dec 13 14:26:00 CST 2015, time=2015-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=40000, encodeId=df75400009e, content=抓住西瓜,丢芝麻, beContent=null, objectType=article, channel=null, level=null, likeNumber=145, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a1a01625167, createdName=zhouxue1990, createdTime=Tue Oct 20 22:45:00 CST 2015, time=2015-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385344, encodeId=277b13853448e, content=<a href='/topic/show?id=9aeb45318ed' target=_blank style='color:#2F92EE;'>#孕激素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45318, encryptionId=9aeb45318ed, topicName=孕激素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=05a2499, createdName=dzx0922889, createdTime=Tue Oct 20 13:26:00 CST 2015, time=2015-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39493, encodeId=2835394934f, content=为了积分我也是拼了~, beContent=null, objectType=article, channel=null, level=null, likeNumber=138, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 12:03:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39491, encodeId=b9f73949128, content=感谢分享~, beContent=null, objectType=article, channel=null, level=null, likeNumber=156, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 12:02:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39492, encodeId=3cc439492b9, content=赞一个~, beContent=null, objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 12:02:00 CST 2015, time=2015-10-19, status=1, ipAttribution=)]
    2015-10-19 sunlong28

    感谢分享~

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1708321, encodeId=ae541e0832122, content=<a href='/topic/show?id=4c2d3051535' target=_blank style='color:#2F92EE;'>#内膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30515, encryptionId=4c2d3051535, topicName=内膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=730431558473, createdName=12498974m61暂无昵称, createdTime=Mon Dec 28 10:26:00 CST 2015, time=2015-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1665601, encodeId=c568166560169, content=<a href='/topic/show?id=685445152f6' target=_blank style='color:#2F92EE;'>#子宫内膜异位#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45152, encryptionId=685445152f6, topicName=子宫内膜异位)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4de125981980, createdName=12498f17m74暂无昵称, createdTime=Mon Feb 15 03:26:00 CST 2016, time=2016-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1991805, encodeId=9a6a19918052e, content=<a href='/topic/show?id=ea25610484f' target=_blank style='color:#2F92EE;'>#术后复发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61048, encryptionId=ea25610484f, topicName=术后复发)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=62e4433, createdName=zz12341234, createdTime=Sun Dec 13 14:26:00 CST 2015, time=2015-12-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=40000, encodeId=df75400009e, content=抓住西瓜,丢芝麻, beContent=null, objectType=article, channel=null, level=null, likeNumber=145, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a1a01625167, createdName=zhouxue1990, createdTime=Tue Oct 20 22:45:00 CST 2015, time=2015-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385344, encodeId=277b13853448e, content=<a href='/topic/show?id=9aeb45318ed' target=_blank style='color:#2F92EE;'>#孕激素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45318, encryptionId=9aeb45318ed, topicName=孕激素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=05a2499, createdName=dzx0922889, createdTime=Tue Oct 20 13:26:00 CST 2015, time=2015-10-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39493, encodeId=2835394934f, content=为了积分我也是拼了~, beContent=null, objectType=article, channel=null, level=null, likeNumber=138, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 12:03:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39491, encodeId=b9f73949128, content=感谢分享~, beContent=null, objectType=article, channel=null, level=null, likeNumber=156, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 12:02:00 CST 2015, time=2015-10-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=39492, encodeId=3cc439492b9, content=赞一个~, beContent=null, objectType=article, channel=null, level=null, likeNumber=168, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/05/26/5e1df344d663496bdfd43c465d409e2c.jpg, createdBy=bce679058, createdName=sunlong28, createdTime=Mon Oct 19 12:02:00 CST 2015, time=2015-10-19, status=1, ipAttribution=)]
    2015-10-19 sunlong28

    赞一个~

    0

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