Application Of Dienogest In Postoperative Treatment Of Ovarian Endometriosis

Objective:To evaluate the effects of dinorgestrel on quality of life and adverse reactions in patients with ovarian endometriosis after long-term management after conservative surgery.Methods:A total of 88 women of childbearing age who had been treated with DNG(2mg/d)for at least 52 weeks after conservative surgery for ovarian endometriosis were followed up.According to the actual situation of medication,the patients were divided into two groups: group A,treated with DNG(2mg/d)immediately after surgery;Group B received Gn RH-a 3-4 times injection followed by DNG(2mg/d).The clinical efficacy was evaluated by comparing the quality of life score(EHP-5 score)and pelvic pain score(VAS score)of the two groups before and after DNG treatment.The safety was evaluated by comparing the incidence of short-term(<12weeks)and long-term(>52weeks)adverse reactions between the two groups.Results:The quality of life and pelvic pain were significantly improved in both groups after DNG treatment.In group A,the median quality of life score(from 42 to 24,P<0.001)and the median pelvic pain score(from 4 to 0.5,P<0.001)were significantly decreased after DNG treatment.In group B,the median quality-of-life score(from 38 to 26,P<0.001)and median pelvic pain score(from 4 to 1,P<0.001)were also significantly reduced before and after treatment,with no significant differences between the two groups.Second,in terms of bleeding patterns,the incidence of adverse bleeding patterns in patients treated with DNG for less than 12 weeks(group A 38.10%,group B 17.39%)was significantly higher than that in patients treated for more than 52 weeks(group A11.90%,group B 6.52%).The incidence of adverse bleeding pattern in patients with Gn RH-a injection 3-4 times before DNG treatment was significantly lower than that in patients with DNG directly after operation.With the increase of time,the amenorrhea rate of the two groups was significantly increased,and the bleeding pattern was improved.In terms of the incidence of other adverse effects,the incidence of patients treated for more than 52 weeks(group A 19.05%,group B 23.91%)was slightly lower than that of patients treated for less than 12 weeks(group A 26.19%,group B 30.43%).Group B13.04%)were more common in patients less than 12 weeks,and other adverse reactions such as breast discomfort,depression,acne,alopecia and leg pain were relatively low.Conclusion:Laparoscopic conservative surgery combined with DNG for ovarian endometriosis can significantly improve the quality of life of patients with endometriosis,and the incidence of adverse reactions is low,with good safety and tolerance.In addition,short-term adjuvant Gn RH-a therapy before DNG treatment can improve the adverse bleeding pattern early in the treatment.