保守性术后辅助药物治疗中、重度子宫内膜异位症128例

Clinical observation of drug therapy after conservative operation on treatment of 128 women with advanced endometriosis

目的观察中、重度子宫内膜异位症病人保守性术后辅助促性腺激素释放激素受体激动药(GnRH-α)、孕三烯酮治疗的临床疗效、安全性及停药后累积复发率、妊娠率及对垂体-卵巢轴内分泌的影响。方法回顾性分析128例中、重度子宫内膜异位症病人,随机分为GnRH-α组、孕三烯酮组和对照组,观察各组的症状缓解率、不良反应、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均较对照组明显提高(P<0.01);GnRH-α组妊娠率和复发率降低(P<0.05);用药后GnRH-α组血清E2、FSH、LH水平有显著变化(P<0.01),孕三烯酮组LH和E2明显降低(P<0.01)。结论在保守性术后加用抑制卵巢功能药物对提高子宫内膜异位症病人的妊娠率、降低复发率有重要作用。

AIM To observe the therapeutic effects, safety, cumulative relapse frequencies, pregnancy rate, and the effects of endocrine response on gonadotropin （hormone） -releasing hormone-analogue （GnRH-α）and gestrinone on endometriosis after conservative operation. METHODS One hundred and twenty-eight patients with endometriosis patients were randomly divided into 3 groups： GnRH-α group, gestrinone group, and the control group. The symptomatic relief rate, adverse reaction, cumulative relapse frequencies, pregnancy rate,and the effects of endocrine response were observed and compared. RESULTS Compared with the control group, the symptomatic relief rate of GnRH-α group and gestrinone group was obviously increased （P 〈 0.01）,and pregnancy rate and relapse rate of GnRH-α group was decreased （P 〈 0.05）. The level of E2, FSH, LH in GnRH-α group were changed obviously （P 〈 0.01 ） , and E2 and LH in gestrinone group was significantly decresed （P 〈 0.01）. CONCLUSION Laparoscopic operation combined with postoperative drug therapy has significant importance for enhancement of fecundity and decrease of relapse rate with endometriosis.