腹腔镜手术结合促性腺激素释放激素激动剂治疗子宫内膜异位症的疗效观察

Efficacy of laparoscopic surgery combined with gonadotropin-releasing hormone agonist in the treatment of endometriosis

目的探究腹腔镜手术联合促性腺激素释放激素激动剂(gonadotropin releasing hormone agonist,Gn RH-a)治疗子宫内膜异位症的临床价值,并分析其对患者血清和腹腔液细胞因子的影响。方法选取本院2014年8月至2015年10月收治的子宫内膜异位症患者72例,按照盲选法分为对照组(单纯腹腔镜手术治疗,36例)和研究组(单纯腹腔镜手术联合Gn RH-a治疗,36例),比较两组患者临床治疗有效率、妊娠情况及复发率,并比较两组患者血清和腹腔液中白介素-6(interleukin-6,IL-6)、糖类抗原125(carbohydrate antigen 125,CA125)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)及血管内皮生长因子(vascular endothelial growth factor,VEGF)水平。结果研究组患者临床治愈率和总有效率均显著高于对照组(P<0.05)。治疗后两组患者血清和腹腔液中IL-6、CA125、TNF-α、VEGF水平均低于治疗前(P<0.05),且研究组上述指标水平均显著低于对照组(P<0.05)。随访期间,研究组患者妊娠率显著高于对照组(P<0.05),复发率显著低于对照组(P<0.05)。结论腹腔镜手术联合Gn RH-a治疗子宫内膜异位症疗效较好,安全性较高。

] Objective To explore the clinical effect of laparoscopy combined with gonadotropin releasing hormone agonist （GnRH-a） in the treatment of endometriosis and the effect on serum and peritoneal fluid cytokines. Method 72 patients with endometriosis from August 2014 to October 2015 in our hospital were randomly selected and divided into research group and control group according to blind selection method, 36 cases in each group. Patients in research group were treated with GnRH-a on the basis of control group. The clinical efficacy, pregnancy status, recurrence, the levels of interleukin-6 （IL-6）, carbohydrate antigen 125 （CA125）, tumor necrosis factor-α（TNF-α） and vascular endothelial growth factor （VEGF） in serum and peritoneal were compared between the two groups. Result The clinical cure rate and total effective rate of the research group were significantly higher than those of control group （P 〈 0.05）. After treatment, the levels of IL-6, CA125, TNF-α and VEGF in serum and peritoneal fluid of the two groups were lower than those of before treatment （P 〈 0.05）, and the above indexes of research group were significantly lower than those of control group （P 〈 0.05）. During the follow-up, the pregnanly rate of the research group was significantly higher than control group （P 〈 0.05）, and the recurrence rate was significantly lower than that of control group （P 〈 0.05）. Conclusion Laparoscopy combined with GnRH-a in the treatment of endometriosis has a high clinical value in improving the efficacy, and has high security.