腹腔镜手术联合药物疗法对子宫内膜异位症伴不孕的疗效观察(附66例报告)

Combined application of laparoscopic operation and drug therapy for endometriosis associated with infertility: with a report of 66 cases

目的:探讨联合应用腹腔镜手术与药物疗法治疗子宫内膜异位症伴不孕的临床效果。方法:随机将2009年3月至2012年7月收治的130例子宫内膜异位症伴不孕患者分为两组,观察组(n=66)与对照组(n=64)。对照组行腹腔镜手术,观察组在对照组前提下加用孕三烯酮。结果:观察组总有效率(98.48%)高于对照组(85.94%),差异有统计学意义(P<0.05)。术后两组患者血清CA125水平均显著下降,与治疗前相比差异有统计学意义(P<0.05);两组间相比差异无统计学意义(P>0.05)。对照组副反应发生率(9.38%)高于观察组(4.55%),但差异无统计学意义(P>0.05)。术后均随访6个月,两组患者妊娠率分别为31.82%(21/66)与17.19%(11/64),两组相比差异有统计学意义(P<0.05)。结论:腹腔镜手术联合药物疗法治疗子宫内膜异位症伴不孕效果理想、安全可靠,优于单纯手术疗法。

Objective ： To explore the clinical therapeutic effect of combination of laparoscopie operation and drug treatment for infertility with endometriosis. Methods：From Mar. 2009 to Jul. 2012, a total of 130 patients with endometriosis and infertility were di- vided into the observation group（ n = 66） and control group（ n = 64）. The control group underwent laparoseopic operation, in the treat- ment group gestrinone and laparoscopy was used, clinical effects were compared between the two groups. Results：The total effective rate of observation group（98.48% ） was higher than that of the control group （ 85.94% ） , difference between the two groups was significant （P 〈0.05）,the serum CAI25 levels after treatment in two groups significantly decreased,there were significant differences compared with the values before treatment （ P 〈 0.05 ）, the differences between the two groups were not significant （ P 〉 0.05 ）. The incidence of adverse reaction in the control group （9.38%） was higher than that in the observation group （4.55%） , but there was not significant difference between the two groups （ P 〉 0.05 ）. All the patients were followed up for 6 months, the pregnancy rate of the observation group and the control group was 31.82% （21/66） and 17.19% （11/64） ,the difference between the two groups was statistically sig- nificant （ P 〈 0.05 ）. Conclusions ： The combined application of laparoscopie operation and drug treatment for infertility with endometri- osis is safe and reliable,its clinical efficacy is satisfactory, better than simple operation.