腹腔镜手术联合促性腺激素释放激素激动剂(GnRH-a)治疗卵巢巧克力囊肿的疗效分析

Efficacy analysis of laparoscopic operation combined with gonadotropin releasing hormone agonist (GnRH-a) in the treatment of ovarian chocolate cyst

目的 探讨腹腔镜手术联合促性腺激素释放激素激动剂（Gn RH-a）治疗卵巢巧克力囊肿的临床疗效。方法选取2012年6月~2013年12月来我院就诊的卵巢巧克力囊肿患者95例,按照随机数字表法分为观察组48例和对照组47例,两组患者均实施腹腔镜下卵巢巧克力囊肿剔除术治疗,观察组行腹腔镜手术治疗后,于术后第1次月经来潮的第2天开始肌肉注射Gn RH-a制剂达菲林。观察两组患者的临床疗效及随访2年的妊娠率。采用免疫化学发光法测定血清卵泡刺激素（FSH）、黄体生成素（LH）、孕酮（P）、雌二醇（E2）水平。结果 观察组的临床总有效率明显高于对照组（97.92%vs 89.36%）,两组比较差异有统计学意义（P〈0.05）。观察组的总妊娠率为70.83%,明显高于对照组的44.68%,差异有统计学意义（P〈0.05）。两组患者治疗前P、FSH、LH、E2比较无显著差异,治疗后FSH、LH升高,P、E2降低,两组比较差异有统计学意义（P〈0.05）。结论 对于卵巢子宫内膜异位囊肿症患者,腹腔镜手术治疗联合辅助Gn RH-a能提高疗效和有益于妊娠率的提高,值得临床应用及推广。

Objective To explore the clinical efficacy of laparoscopic operation combined with gonadotropin releasing hormone agonist（GnRHa） in the treatment of ovarian chocolate cyst. Methods From June 2012 to December 2013,95 patients with ovarian chocolate cyst in our hospital were selected and divided into observation group（48 cases） and control group（47 cases）. The patients of two groups were treated with laparoscopic ovarian chocolate cyst excision,and the patients of observation group was treated with laparoscopic operation and began to intramuscular injection of GnRHa preparation Diphereline after the first menstruation 2 days. The clinical efficacy of the two groups were observed and the pregnancy rate after 2 years were followed up. Serum follicle stimulating hormone（FSH）, progesterone（LH）,progesterone（P） and estradiol（E2） levels were measured by immune chemiluminescence. Results The clinical total effective rate of observation group was significantly higher than that of control group（97.92% vs 89.36%）, the difference between two groups was significant（P0.05）. The pregnancy rate of observation group was 70.83%, which significantly higher than that of control group（44.68%）,the difference between two groups was significant（P0.05）. The P, FSH,LH, E2 of two groups had no significant difference before treatment. After treatment, FSH, LH were increased, P, E2 were decreased,and the differences of two groups were significant（P0.05）. Conclusion For ovarian endometriosis patients,the treatment method that laparoscopic operation combined with gonadotropin releasing hormone agonist（GnRHa） can improve the effect and the pregnancy rate, and it is worthy of clinical application and promotion.