腹腔镜手术联合孕三烯酮治疗卵巢子宫内膜异位症的临床观察——108例分析

Clinical Observation of Combinative Treatment on Ovarian Endometriosis with Laparoscopy and Gestrinone——108 Cases

目的:探讨腹腔镜手术联合孕三烯酮治疗卵巢子宫内膜异位症的远期疗效及安全性。方法:随机选择2003.08～2004.12我院经腹腔镜手术诊断的卵巢子宫内膜异位症患者108例(1例失访已除外),将术后给予孕三烯酮治疗的58例设为研究组,未给予的50例设为对照组。研究组于术后第一次月经后开始服用孕三烯酮2.5 mg,每周两次,连用3-6个月。对照组不用药。所有患者随访6个月～3年观察疗效。结果:两组患者均通过腹腔镜完成手术。随访率99.08%,研究组与对照组的总有效率分别为86.21%和64.00%,两组相比差异有显著性(P<0.01),复发率分别为10.34%和31.25%,两者相比有统计学意义(P<0.01)。34例不孕及要求妊娠者共有18例受孕。结论:腹腔镜术后联合孕三烯酮治疗卵巢子宫内膜异位症疗效确切,能降低复发率,提高受孕,且副反应小。

Objective： To investigate the long-term effects and safety of combinative treatment with laparoscopy and gestrinone on ovarian endometriosis. Methods： 108 cases diagnosed ovarian endometriosis were divided into two groups： the study group （n=58） and the control group （n=50） by laparoscopy during August, 2003 to December, 2004. The patients in study group were given 2.5 mg of gestrinone twice a week for 3-6 months after operation. The cases in control group had not taken any hormone. All patients were followed up 6 months to 3 years to observe curative effect, and 1 of them lost. Results： All patients were successfully treated by laparoscopic operation, and the follow-up rate was 99.08 %. The total effective rate had statistical significance between the study group （86.21%） and the control group （64.00 % ） （P〈0.01 ）. The recurrence rate of study group was 10.34 %, which was significantly lower than that of control group （31.25%） （P〈0.01）. 18 of 34 cases with infertility and pregnancy request had pregnancy. Conclusion： Gestrinone is a safe and effective therapeutic means for ovarian endometriosis, which can significantly decrease the recurrence rate and increase the pregnancy rate.