子宫内膜异位症患者腹腔镜术后应用促性腺激素释放激素激动剂的有效性及安全性研究

Study on the effectiveness and safety of using gonadotropin releasing hormone agonist after laparoscopic surgery in patients with endometriosis

目的研究分析子宫内膜异位症患者腹腔镜术后应用促性腺激素释放激素激动剂(GnRH-a)的有效性及安全性。方法选取子宫内膜异位症患者100例,随机分成观察组和对照组,各50例;观察组患者行腹腔镜术后,自恢复月经第1天开始,每4周皮下注射GnRH-a 3.75 mg,连续治疗3个月,对照组仅行腹腔镜术治疗;收集各患者术后两年内的随访资料,对两组患者的疼痛度、复发率和妊娠率进行比较。结果观察组患者术后无痛、轻度疼痛患者比率明显高于对照组,差异具有统计学意义(P<0.05)。术后两年随访期间,观察组患者术后复发率(6.0%)明显低于对照组(28.0%),妊娠率(78.0%)明显高于对照组(40.0%),差异均具有统计学意义(P<0.05)。结论与单纯腹腔镜手术相比,术后联合促性腺激素释放激素激动剂治疗子宫内膜异位症能明显改善症状,使疼痛减轻,降低复发率,提高术后妊娠率。

Objective To analyze the effectiveness and safety of using gonadotropin releasing hormone agonist in patients with endometrio-sis after laparoscopic surgery. Methods One hundred patients with endometriosis were allocated in this study. They were randomly divided into observation group and control group（n = 50,respectively）. Patients in observation group were administered with GnRH - a injection once since the first day of recovery of menstruation after surgery. Each patient was administered 3. 75 mg every four weeks,continued for three months. In the mean time,no adjuvant therapy was given to patients in the control group. The data of patients were collected after follow - up for two years. The degree of pain in patients,recurrence rate and pregnancy rate were compared between these two groups. Results The ratio of mild postoperative pain and painless patients in observation group was significantly higher than that of control group,and the difference was statistically significant（ P ﹤ 0. 05）. During the follow - up period for two years after surgery,the recurrence rate in observation group（6. 0% ）was lower than that of con-trol group（28. 0% ）. In the same time,the pregnancy rate in observation group（78. 0% ）was higher than that of control group（40. 0% ）,and the difference was statistically significant（ P ﹤ 0. 05）. Conclusion In comparison with laparoscopic surgery,combination with gonadotropin re-leasing hormone agonist can significantly remit the symptoms of endometriosis and relieve the pain,reduce the rate of relapse and raise the rate of pregnancy after treatment.