子宫内膜异位症腹腔镜保守手术后不同延续用药治疗的临床观察

Clinical observation of different drugs in treatment of endometriosis after laparoscopy operation

目的:探讨子宫内膜异位症腹腔镜保守手术后不同延续用药对预后的影响。方法:腹腔镜下子宫内膜异位症保守手术的Ⅲ期、Ⅳ期子宫内膜异位症患者160例。其中A组43例,术后不用药;B组53例,术后加用促性腺激素释放激素激动剂(GnRH-a)治疗(曲普瑞林);C组64例,术后加用短效避孕药炔雌醇环丙孕酮(达英-35)。比较3组患者术后症状缓解率、复发率及受孕率。结果:3组的术后2年症状缓解率无统计学差异(P>0.05);B、C组的复发率低于A组(P<0.05),B组的复发率低于C组(P<0.05);B、C组的受孕率高于A组(P<0.05)。结论:中重度子宫内膜异位症腹腔镜手术治疗后加用曲普瑞林或达英-35巩固治疗,能降低复发率并提高受孕率,且曲普瑞林的疗效优于达英-35。

Objective：To explore the effect of different continure medication on prognosis after laparoscope conservative operation of endometriosis.Methods：The postoperative women were divided into 3 groups：35 without endocrinal therapy（group A）,43 treated with gonadotropin releasing hormone agonist（GnRH-a）（3.75 mg,once every 28 d,group B）,51 treated with Diane-35（1 tablets every day,group C）.The remission rate,recurrent rate and incidence of adverse drug reactions were compared.Results：The postoperational 2 year symptom alleviation rate among 3 groups had no significance（P0.05）.The recurrence rate of Group B and C was lower than that in Group A（P0.05）,but that of Group B was lower than that of Group C（P0.05）,the conception rate of Group B and C was higher than that of Group A（P0.05）.Conclusion：Laparoscope conservative postoperation combined triptorelin or Diane-35 in moderate and severe endometriosis could consolidate therapeutic effect,reduce recurrent and conception rate,and triptorelin has the better effect than Diane-35.