腹腔镜手术前后联合曲谱瑞林治疗IV期子宫内膜异位症的比较分析

Comparison of the curative effects of triptorelin before and after laparoscopic surgery in treatment of stage Ⅳ endometriosis

目的：探讨腹腔镜手术与曲谱瑞林联合治疗Ⅳ期子宫内膜异位症（EM）的最优方式。方法：对62例Ⅳ期EM患者行回顾性分析，32例于腹腔镜术后肌注曲谱瑞林，3．75mg，每月1次，连续3月；30例先使用3个月曲谱瑞林后再手术，用法同前。比较二者围手术期情况和远期预后。结果：两组手术时间分别为（126±29）min和（79±26）min，出血量为（390±32）ml和（180±60）ml，差异均有显著性（P〈0．05）。随访2～5年，其妊娠率、复发率及盆腔疼痛缓解率差异均无显著性（P〉0．05）。结论：与术后使用GnRH—a类药物相比，腹腔镜手术前用药疗效相似，但更有利于手术的实施。

Objective：To compare the curative effects of triptorelin before and after laparoscopic surgery in treatment of stage Ⅳ endometriosis. Methods： A retrospective study was conducted on 62 patients with stage Ⅳ endometriosis, 32 managed with triptorelin preoperatively and another 30 postoperatively, both at the same dosage of 3.75 mg by intramuscular injection monthly for 3 months. Mean operative duration, mean blood loss, pregnancy rates, recurrence rates and pain relieving rates were recorded and compared between the two groups. Results： Mean operative durations for the two groups were （ 126 ± 29 ） min and （ 79± 26 ） min respectively, with significant difference, and the volumes of mean blood loss were （ 390 ± 32 ） ml and （ 180 ± 60 ） ml, respectively, with significant difference between them as well （P 〈 0. 05） . For the two to five years of follow - up, no differences between them were found in respect of pregnancy rate, recurrence rate and pain relieving rate （P 〉 0.05 ）. Conclusion： Compared with injection of triptorelin after laparoscopic operation in the treatment of stage Ⅳ endometriosis, administration of triptorelin before that operation appears also effective, and it can facilitate subsequent surgical manipulation.