卵巢子宫内膜异位囊肿在腹腔镜术前应用GnRH-a的临床疗效分析

Clinical analysis of GnRH-a in the treatment of ovarian endometriosis cyst before laparoscopic surgery

目的探讨卵巢子宫内膜异位囊肿腹腔镜术前应用促性腺激素释放激素类似物(GnRH-a)的临床价值。方法选择2012年4月—2015年5月中信惠州医院妇产科收治的卵巢子宫内膜异位囊肿患者90例,按入院顺序随机分为观察组和对照组各45例。观察组患者于术前采用GnRH-a药物皮下注射,对照组患者术前未使用GnRH-a药物。对比分析2组患者围术期相关指标,治疗后的激素水平、卵泡相关指标及随访结果。结果观察组手术时间及恢复排气时间均短于对照组,术中出血量明显少于对照组,2组比较差异有统计学意义(P<0.01)。观察组患者的激素(LH、FSH、LH/FSH、E_2)水平指标均明显低于对照组,2组比较差异有统计学意义(P<0.01)。观察组卵巢体积、窦卵泡个数明显小/少于对照组,优势卵泡的个数明显多于对照组,2组比较差异有统计学意义(P<0.01)。观察组疼痛缓解率及妊娠率明显高于对照组,观察组复发率明显低于对照组,2组比较差异有统计学意义(P<0.05)。结论卵巢子宫内膜异位囊肿腹腔镜术前应用GnRH-a药物注射,可以降低手术难度,提高手术的疗效,且有利于患者远期预后和改善。

Objective To investigate the clinical value of gonadotropin releasing hormone analogue（GnRH-a） before laparoscopic surgery for ovarian endometriosis cysts.Methods From April 2012 to May 2015,90 cases of ovarian endometriosis cysts were treated in the department of obstetrics and Gynecology in CITIC Huizhou Hospital were enrolled.They were randomly divided into the observation group and the control group,45 cases each.The patients in the observation group received subcutaneous injection of GnRH-a before operation,and the control group did not use GnRH-a before operation.The relative indexes of perioperative period,hormone levels,follicular related indexes and follow-up results were analyzed and compared between the 2 groups.Results The operation time and recovery time of the observation group were shorter than that of the control group,and the amount of bleeding during operation was significantly less than that of the control group,and the difference between the 2 groups was statistically significant（P 0.01）.The levels of hormones（LH,FSH,LH/FSH,E_2）in the observation group were significantly lower than those in the control group,and the difference between the 2 groups was statistically significant（P 0.01）.The ovarian volume and the number of antral vesicles were significantly smaller in the observation group than in the control group,and the number of dominant follicles was significandy higher than that of the control group,and the difference between the 2 groups was statistically significant（P 0.01）.The pain relief rate and pregnancy rate of the observation group were significantly higher than that of the control group,and the recurrence rate of the observation group was significantly lower than that of the control group,the difference between the 2 groups was statistically significant（P 0.05）.Conclusion The use of GnRH-a injection before laparoscopic surgery for ovarian endometriosis cysts can reduce the difficulty of operation,improve the curative effect,and benefit the long-term prognosis.