亮丙瑞林辅助腹腔镜治疗子宫内膜异位症临床疗效评价

Clinical Evaluation on Leuprolide Assisted Laparoscopy in Treating Endometriosis

目的探讨亮丙瑞林辅助腹腔镜治疗子宫内膜异位症的临床疗效及对患者再孕和生活质量的影响。方法选取医院2013年1月至2016年1月收治的首次接受腹腔镜下手术的子宫内膜异位症患者184例,回顾性分析所有患者的临床及随访资料,根据治疗方法不同分为A组68例、B组64例和C组52例。A组患者采用腹腔镜手术等临床常规治疗,B组患者在手术治疗后予以亮丙瑞林治疗3个月,C组在手术治疗后予以亮丙瑞林治疗6个月。结果治疗后,3组患者的卵泡刺激素和黄体生成素水平均较治疗前明显下降,且B组和C组患者下降程度均显著大于A组(P<0.05),但B组和C组间无明显差异(P>0.05);3组患者临床总有效率比较,差异无统计学意义(χ~2=1.828,P>0.05);随访1年后,B组和C组患者的再孕率分别为78.13%和80.77%,均显著高于A组患者的47.06%(χ~2=20.383,P<0.01),但B组和C组无明显差异(P>0.05);治疗后,B组和C组患者生活质量评分显著高于A组(P<0.05),但B组和C组间无明显差异(P>0.05)。结论腹腔镜下术后予亮丙瑞林辅助治疗3～6个月子宫内膜异位症,可显著提高患者临床有效率、再孕率及生活质量,具有一定安全性,值得推广。

Objective To investigate the clinical effect of leuprolide assisted laparoscopy in the treatment of endometriosis and its effect on re-pregnancy and the quality of life. Methods Totally 184 patients with endometriosis admitted to our hospital from January 2013 to January 2016 were selected. The clinical and follow-up data of all the patients were analyzed retrospectively. All the patients were divided into group A（ 68 cases）, group B（ 64 cases） and group C（ 52 cases） according to the different treatment methods. The patients in group A were treated with laparoscopy and other routine clinical treatments,the patients in group B were treated with leuprorelin for3 months after operation,and the patients in group C were treated with leuprorelin for 6 months after operation. Results After treatment,the levels of FSH and LH in the three groups were significantly decreased compared with before treatment,and the decrease in group B and group C was more significant than that in group A（ P 〈 0. 05）,but there was no significant difference between group B and group C（ P 〉 0. 05）. There was no significant difference in the total effective rate among the three groups（ χ~2= 1. 828, P 〉 0. 05）. After1 year of follow-up,the re-pregnancy rates of patients in group B and group C were 78. 13% and 80. 77%,respectively,which were significantly higher than 47. 06% in group A（ χ~2= 20. 383, P 〈 0. 01）, but there was no significant difference between group B and group C（ P 〉 0. 05）. After treatment,the scores of quality of life in group B and group C were significantly higher than that in group A（ P 〈 0. 05）, but there was no difference between group B and group C（ P 〉 0. 05）. Conclusion After laparoscopic operation,leuprolide in the adjuvant treatment of endometriosis for 3 months to 6 months can significantly improve the clinical effect,re-pregnancy rate and quality of life of the patients with endometriosis,it has certain safety and is worthy of promotion.