促性腺激素释放激素激动剂在腹腔镜治疗内异症中的效果分析

An analysis of the effect of gonadotrophin-releasing hormone agonists in the laparoscopic treatment of Endometriosis

目的：探讨促性腺激素释放激素激动剂（GnRH-a）在腹腔镜治疗内异症中的效果。方法以我院2011年7月～2013年7月间收治的100例内异症患者为研究对象，随机分为观察组与对照组，所有患者均使用腹腔镜对内异症进行手术，观察组患者在此基础上增加使用GnRH-a，比较两组患者手术效果、术后激素水平、康复期临床症状及复发率之间的差异。结果观察组手术时间、术中出血量、术后通气时间、下床活动时间分别为（68.21±12.94）min、（112.73±35.94）mL、（28.93±4.82）h和（25.49±4.01）h，对照组分别为（82.67±10.27）min、（168.39±41.82）mL、（34.39±3.08）h和（32.10±4.20）h，观察组患者手术效果优于对照组。观察组促卵泡激素、雌二醇和骨钙素水平分别为（3.28±1.93）U/L、（57.48±15.02）pmol/L和（17.59±5.40）μg/L，对照组为（5.03±1.48）U/L、（88.39±13.84）pmol/L和（18.21±6.02）μg/L，观察组术后激素水平低于对照组，其康复期症状得分亦总体低于对照组。观察组患者复发或无效率为6.00%，对照组为22.00%，观察组患者术后复发及无效率低于对照组，上述比较差异皆具有统计学意义（P＜0.05）。结论GnRH-a在腹腔镜治疗内异症中可以起到积极效果，其可提高手术效果、抑制患者激素水平、改善患者临床症状、降低复发率。

Objective To explore the effect of gonadotrophin-releasing hormone agonists（GnRH-a） in the laparoscopic treatment of endometriosis. Methods 100 patients with endometriosis who were admitted in our hospital from July 2011 to July 2013 were selected as research subjects and randomly allocated to an observation group and a control group. All patients received laparoscopy for treating endometriosis, and the observation group further received GnRH-a. Operative effect, postoperative hormone levels, clinical symptoms during convalescence and relapse rate were compared between the two groups. Results Surgery time, amount of bleeding during surgery, time of postoperative passage of gas and exercise time were（68.21±12.94） min,（112.73±35.94） mL,（28.93±4.82） h and （25.49±4.01） h respectively in the observation group, and（82.67±10.27） min,（168.39±41.82） mL,（34.39±3.08） h and （32.10±4.20） h respectively in the control group, and the operative effect in the observation group was better than that in the control group. Levels of follicle-stimulating hormone, estradiol and osteocalcin were（3.28±1.93） U/L,（57.48±15.02） pmol/L and（17.59±5.40） μg/L respectively in the observation group, and（5.03±1.48） U/L, （88.39±13.84） pmol/L and（18.21±6.02）μg/L respectively in the control group. The postoperative hormone levels in the observation group were lower than those in the control group, and the scores of symptoms during convalescence were lower than those in the control group. Relapse rate or ineffective rate was 6.00% in the observation group and 22.00% in the control group, and the relapse rate or ineffective rate in the observation group was lower than that in the control group. The differences above were all statistically significant（P 〈 0.05）. Conclusion GnRH-a in the laparoscopic treatment of endometriosis has an active effect, which improves operative effect, inhibits patients’ hormone levels, alleviate patients’clinical symptoms and reduces relapse rate.