促性腺激素释放激素激动剂a不同药物巩固时间对子宫内膜异位症腹腔镜手术治疗效果影响

Treatment effect of gonadotropin releasing hormone agonist-a different drug consolidation therapy time on endometriosis patients received endometriosis laparoscopic surgery

目的：探讨促性腺激素释放激素激动剂（ GnRH） a不同药物巩固时间对子宫内膜异位症腹腔镜手术治疗效果的影响。方法选择2012年5月至2014年3月在我院接受腹腔镜治疗的子宫内膜异位症患者70例为研究对象，应用计算机随机分为两组，术后GnRH.a治疗时间分别为6个月和3个月，比较两组患者激素水平、炎症递质、随访情况及治疗效果。结果6个月组总有效率为97.14％（34／35），明显高于3个月组[80.00％（28／35）]，差异有统计学意义（χ2＝5.081，P＜0.05）；治疗后6个月组患者血清促卵泡激素（FSH）、黄体生成素（LH）、雌二醇（E2）均低于3个月组[（2.42±0.33）、（3.79±0.42） U／L，（3.49±0.45）、（5.12±0.60） U／L，（89.48±10.23）、（130.48±16.85） ng／L]，差异均有统计学意义（t值分别为15.174、12.858、12.305，P均＜0.05）；治疗后6个月组患者血清TNF.α、IL.6、IL.8均低于3个月组[（18.48±2.23）、（31.49±4.05） ng／L，（14.45±2.18）、（23.49±2.95） ng／L，（35.29±4.52）、（58.49±7.28） ng／L]，差异均有统计学意义（t值分别为16.648、14.580、16.017，P均＜0.05）；6个月组妊娠率、疼痛缓解率明显高于3个月组[51.43％（18／35）与22.86％（8／35），74.29％（26／35）与40.00％（14／35）]，复发率明显低于3个月组[8.57％（3／35）与31.43％（11／35）]，差异均有统计学意义（χ2值分别为6.118、8.400、5.714，P均＜0.05）。结论腹腔镜手术后进行6个月GnRH.a治疗有助于预防疾病复发、调节激素水平、抑制炎症反应、提高治疗效果。

Objective To study the treatment effect of gonadotropin releasing hormone agonist.α（ GnRH.α） different drug consolidation therapy time on endometriosis patients received endometriosis laparoscopic surgery.Methods Seventy cases endometriosis patients received endometriosis laparoscopic surgery in the People＆#39;s Hospital of Meizhou from May 2012 to March 2014 were enrolled for study and randomly divided into 6 months group and 3 months group according to different time of GnRH.αtreatment.Then hormone levels, inflammatory mediators, follow.up condition and treatment outcome were compared between the two groups.Results The total effective rate of 6 months group was 97.14%（ 34/35） ,significantly higher than that of 3 months group（80.00%（28/35））,the difference was significant（χ2 =5.081,P〈0.05）.Serum follicle stimulating hormone（ FSH） ,progesterone（ LH） ,estradiol（ E2） levels of 6 months group were significantly lower than 3 months group,the differences were significant（（2.42±0.33） U/L vs.（3.79±0.42）,（3.49±0.45） U/L vs.（5.12±0.60） U/L,（89.48±10.23） ng/L vs. （130.48±16.85） ng/L;t=15.174,12.858,12.305;P〈0.05）.Serum TNF.α,IL.6,IL.8 levels of 6 months group were significantly lower than 3 months group,the differences were significant（（18.48±2.23） ng/L vs.（31.49±4.05） ng/L,（14.45±2.18） ng/L vs.（23.49 ±2.95） ng/L,（35.29±4.52） ng/L vs. （58.49±7.28） ng/L;t=16.648,14.580,16.017;P〈0.05）.The pregnancy rate,pain relief rate of 6 months group were significantly higher than 3 months group（51.43%（18/35） vs.22.86%（8/35）,74.29%（26/35） vs.40.00%（14/35））,the recurrence rate was significantly lower than that 3 months group（8.57%（3/35） vs.31.43%（11/35））,the differences were significant（χ2=6.118, 8.400,5.714;P〈0.05）.Conclusion 6 months GnRH.α treatment after laparoscopic surgery help to prevent disease relapse,and regulate hormone levels,inhibit inflammatory reaction,then improve the effect of treatment.