腹腔镜手术联合GnRHa治疗卵巢子宫内膜异位症的预后分析摘要

The prognostic analysis of GnRHa following conservative laparoscopic surgical treatment for ovarian endometriosis

目的分析卵巢子宫内膜异位囊肿接受腹腔镜保守治疗，术后辅助使用与不用促性腺激素释放激素激动剂（gonadotropin-releasing-hormoneagonist，GnRHa）的近期、远期复发率和妊娠率。方法收集2008年1月一2011年7月在我院妇科行腹腔镜保守手术治疗并经病理证实为卵巢子宫内膜异位囊肿症的患者，按术后辅助使用GnRHa与否，分为单纯手术组和联合用药组。随访截止到2012年12月，比较两组患者的复发率和妊娠率。结果共有195例患者接受治疗，最后183例患者纳入分组，为单纯手术组59例，联合用药组124例。单纯手术组总妊娠率、6月和1年妊娠率分别为45．8％、22．0％和39．0％；联合用药组为55．6％、9．7％和29．0％，两组6月妊娠率差异有统计学意义，其余差异无统计学意义。单纯手术组总复发率、6月和1年复发率分别为10．2％、5．1％和6．8％；联合周药组为11．3％、1．6％和6．5％，两组差异无统计学意义。结论对于卵巢子宫内膜异位囊肿症患者，在腹腔镜手术治疗以及术后辅助GnRHa相比较能降低复发率和有益于妊娠率的提高。

Objective To investigate the short-term and long-term recurrence rate and pregnancy rate of adjuvant treatment with gonadotropin-releasing-hormone agonist （GnRHa） following conservative laparoscopic surgical treatment of ovarian endometriosis. Methods Patients with ovarian endometriosis undergoing conservative laparoscopic surgery in our Hospital from January 2008 to July 2011 were collected. All the patients were grouped in two groups surgery alone group and combination group. Subsequent follow-up of the surviving patients until the end of De recurrence rate and were compared. Results was performed c 2012 and the pregnancy rate A total of 195 patients with ovarian endometriosis underwent surgical patients, and 124 included conservative laparoscopic treatment and finally 183 59 in surgery alone group in combination group, were in the analysis. The total pregnancy rate, six-month pregnancy rate and one-year pregnancy rate were 45.8%, 22.0% and 39.0% in alone group and 55.6%, 9 29.0% in combination group surgery 7% and There was significant difference between two groups in six-month pregnancy rate （P〈0.05）; The total recurrent rate, six-month recurrent rate and one-year recurrent rate were 10.2% 5.1% and 6. 8% group and 11.3% in surgery alone 1.6% and 6.5% in combination group. There was no significant difference between two groups in terms of total recurrent rate, six-month recurrent rate, one-year recurrent rate and five-year recurrent rate. Conclusion GnRHa treatment after operative laparoscopy for ovarian endometriosis does not appear to be in terms of superior to prevention of recurrence and has no improvement on pregnancy rate.