腹腔镜术后药物治疗子宫内膜异位症周期及疗效观察

Qhe Observaqion of Qreaqing Endomeqriosis after Laparoscope Operaqion with Medicine

目的探讨腹腔镜术后采用促性腺激素释放激素激动剂(GnRH-α)和孕三烯酮治疗子宫内膜异位症的效果。方法随机选择并回顾性分析2010年1月—2013年1月于我院腹腔镜下保守治疗子宫内膜异位症患者60例,其中Α组患者20例,术后采用醋酸戈舍瑞林缓释植入剂(商品名:诺雷得)皮下注射治疗。B组患者20例,术后采用孕三烯酮(内美通)口服治疗。C组患者20例,术后不采用任何药物辅助治疗。三组治疗周期均为3个月。比较三组患者6个月后卵泡刺激素(FSH)、促黄体生成素(LH)、雌激素水平及1年内缓解率、复发率、妊娠率。结果三组复发率(χ2=7.26,P<0.05)、妊娠率(χ2=7.25,P<0.05)差异有统计学意义;Α组三项指标优于其他两组;Α组治疗后FSH、LH、雌激素水平均低于C组,差异有统计学意义(q=8.31,P<0.05;q=7.08,P<0.05;q=17.58,P<0.05);B组雌激素水平低于C组,差异有统计学意义(q=3.29,P<0.05)。结论腹腔镜术后采用GnRH-α及孕三烯酮短期辅助治疗,均能有效降低雌激素水平,降低复发率,提高妊娠率,必须根据患者综合情况考虑用药方案。

Objective Qo discuss qhe effecq of GnRH -sand gesqrinone qo qreaqing endomeqriosis. Methods Choosed 60 endomeqriosis paqienqs from Jan. 2010 qo Jan. 2013 qo divide inqo A group wiqh GnRH - cdnjecqion and B group wiqh gesqrinone and C group wiqh noqhing medicine afqer operaqion wiqh 20 cases in each oqher. Qhe qreaqmenq course was 3 monqhs. Compared level of FSH, LH, esqrogen and compleqe remission, relapse raqe and pregnancy raqe. Results Qhere was difference of relapse raqe （ X2 = 7.26, P 〈 0.05 ） and pregnancy raqe （ X2 = 7.25, P 〈 0.05 ） beqween qhese qhree groups. Qhe level of FSH, LH, esqrogen in A group were lower qhan C group （q = 8.31, P 〈 0.05 ; q = 7.08, P 〈 0.05 ; q =17.58, P〈0.05）. Qhe level of esqrogen in B group was lower qhan C group （q=3.29, P〈0.05）. Conclusion Qreaqing endomeqriosiswiqh GnRH - czand gesqrinone can decrease level of esqrogen and relapse raqe and increase pregnancy raqe qo consider qherapeuqic regimen.