腹腔镜联合GnRH-a治疗Ⅰ期子宫内膜异位症不孕的临床研究

Clinical study of laparoscopy combined with GnRH-a in the treatment of stage Ⅰ endometriosis infertility

目的:探讨腹腔镜联合促性腺激素释放激素类似物治疗Ⅰ期子宫内膜异位症合并不孕患者的临床疗效。方法:将2014年1月至2015年1月收治的60例Ⅰ期子宫内膜异位症合并不孕患者按照随机数字表法平均分为治疗组与对照组,每组30例,对照组行腹腔镜手术治疗,治疗组在对照组治疗基础上加用促性腺激素释放激素类似物治疗,对比两组患者的治疗效果。结果:治疗组患者血清卵泡刺激素、雌二醇及促黄体生成素水平均较对照组显著降低(P<0.05);术后1年内妊娠率治疗组为70.00%,高于对照组的43.33%,差异有统计学意义(P<0.05);治疗组术后1年复发率为6.67%,对照组为26.67%,组间相比差异有统计学意义(P<0.05)。结论:对于Ⅰ期子宫内膜异位症合并不孕患者,在腹腔镜手术治疗后加用促性腺激素释放激素类似物治疗,可有效改善性激素水平,提高1年内妊娠率,降低子宫内膜异位症复发率。

Objective： To investigate the clinical efficacy of laparoscopy combined with gonadotropin-releasing hormone analogue in the treatment of patients with stage Ⅰ endometriosis infertility. Methods： Sixty patients of endometriosis with infertility from Jan. 2014 to Jan. 2015 were randomly divided into treatment group and control group（ 30 cases in each group）. The control group received laparoscopic surgical treatment,and treatment group received laparoscopic surgical combined with gonadotropin-releasing hormone analogue therapy. The treatment effect of two groups were compared. Results： After treatment,the levels of follicle-stimulating hormone,estradiol and luteotropic hormone in treatment group were significantly lower than those in control group（ P〈0. 05）; In the treatment group,the pregnancy rate in 1 year after operation was 70. 00%,which was higher than 43. 33% in the control group（ P 0. 05）;The recurrence rate of the treatment group in 1 year after operation was 6. 67%,control group was 26. 67%,the difference was statistically significant（ P 0. 05）. Conclusions： For patients with stage Ⅰ endometriosis and infertility,laparoscopic surgery followed by gonadotropin-releasing hormone analogue can effectively improve the level of gonadal hormone and the pregnancy rate in 1 year,reduce the recurrence rate of endometriosis.