腹腔镜保守性术后辅助药物治疗中重度子宫内膜异位症的临床疗效观察

Clinical Observation of Drug Therapy after Conservative Laparoscopic Operation on Treatment of Advanced Endometriosis

目的观察中重度子宫内膜异位症患者腹腔镜保守性术后辅助GnRH-a和孕三烯酮治疗的临床疗效、副作用及停药后累积复发率、妊娠率、对垂体-卵巢轴内分泌的影响。方法42例中重度子宫内膜异位症的患者随机分为GnRH-a组、孕三烯酮组和对照组,观察各组的症状缓解率、副作用、累积复发率和血清性激素水平变化。结果各用药组的症状和体征缓解率、妊娠率均较对照组明显提高,复发率降低。结论在腹腔镜保守性术后加用抑制卵巢功能药物提高子宫内膜异位症患者的妊娠率、降低复发率有重要作用。

Objective To observe the therapeutic and side effects, cumulative relapse frequencies and pregnancy rate and the effects of endocrine response of gonadotropin（hormone）- releasing hormone -analogue （GnRH-a）and synthesis progesterone（gestrinone）on endometriosis after conservative laparoscopic operation. Methods 42 cases of endometriosis patients were randomly divided into 3 groups： GnRH-a group; gestrinone group and the control group. The symptomatic relief rate, side effect, cumulative relapse frequencies, pregnancy rate and the effects of endocrine response were observed and compared. Results Compared to the control group, the symptomatic relief rate, side effect, relapse rate, pregnancy rate and the effects of endocrine response of the drug-treatment groups（GnRH-a group and gestrinone group） were obviously increased. Conclusions laparoscopic operation combined with post operative endocrinal therapy has significant importance for enhancement of fecundity and decreasing relapse rate with endometroiosis.