Clinical Evaluation Of Non-operative Diagnosis And Therapy Of The Ectopic Endometrial Disease

Objective To investigate the Clinical diagnostic value of non-operativemethod for endometriosis and the effects of different drugs for treating patientswith endometriosis. Methods Patients collected because of chronic pelvic painat the affiliated hospital of Ningxia Medical University from Jan.2011to Jul.2012.279endometriosis was elected according to pelvic pain; pelvic tenderness nodulescombined ultrasound, serum CAl25. All the cases divided into the surgicaltreatment group, the drug treatment group and the control group; compare thedifferent of pelvic pain, pelvic tenderness nodules, ultrasound and serum CAl25after treatment. The sensitivity, specificity, positive predictive value, and negativepredictive value either in each clinical index including pelvic pain, pelvictenderness nodules combined ultrasound, serum CAl25or combined clinicalindexes were calculated by clinical epidemiological method. Compare thedifferent effects after3kinds of drug treatment. Results By pelvic pain, pelvictenderness nodules combined ultrasound, serum CAl25four indicators to evaluatethe endometriosis disease (1) In the surgical treatment group, endometriosispatients occupied76.25%; In each clinical index, the sensitivity of ultrasound isthe highest80.33%, the specificity of pelvic tenderness nodules is the highest57.91%; Any single use of clinical indexes achieved poor sensitivity andspecificity. when combined clinical indexes were used either by parallel test withany two clinical indexes. The sensitivity of pelvic pain and ultrasound is89.90%. (2)All the clinical indexes improved in the surgical treatment group and the drugtreatment groups, especially in surgical treatment group, such as pelvic pain（P=0.00、 P=0.00）, ultrasound （Psurgicalovarian=0.00、 Pdrugovarian=0.04、Psurgicaluterine=0.00、Pdruguterine=0.01） and serum CAl25（P=0.00、P=0.01）, pelvictenderness nodules （Ptenderness=0.00、Ptenderness=0.01，Pvolume=0.00、Pvolume=0.04）,and the control group has not change.(3) The treatment of Mifepristone capsules,gestrinone capsules, Sanjie Analgesic Capsules, the evaluation of pelvic painaccording to VRS, Mifepristone(P=0.00), gestrinone(P=0.01), Sanjie Analgesic(P=0.04), had statistical significance. The volume of ovaries and uterus byultrasound after treatment, in the group comparisons P<0.05, had statisticalsignificance. The serum CA125after treatment, in the group comparisons P<0.05,had statistical significance. In pelvic tenderness nodules, the tenderness decreasesignificantly,68.97%、74.19%、60.61%. Conclusions (1)The non-operativediagnostic indexes such as pelvic pain, pelvic tenderness nodules, ultrasound andserum CAl25were feasibility.(2)High sensitivity and specificity was found withcombined clinical indexes than in each clinical index. The sensitivity of pelvicpain combined ultrasound was highest，the specificity of pelvic tenderness nodulescombined serum CA125was highest.(3)Each clinical index was relieved afterusing drugs.(4) The gestrinone capsules had better effect in reduce serum CAl25and lesion volume. The mifepristone capsules had better effect in reduce pelvicpain.