腹腔镜联合罗氏内异方治疗中、重度子宫内膜异位症相关不孕的疗效观察

Observation on the Curative Effect of Laparoscopic Combined with Luo's Internal Prescription for Severe Endometriosis Related Infertility

目的探讨腹腔镜联合罗氏内异方在治疗中、重度子宫内膜异位症中的价值。方法收集2015年1月~2016年5月我院收治的中、重度子宫内膜异位症患者34例,根据腹腔镜手术后接受的不同治疗,将患者分为LSF组与Gn RH-a组,每组17例。两组患者均在行腹腔镜保守性手术后接受治疗,LSF组给予口服罗氏内异方治疗,Gn RH-a组给予皮下注射诺雷得治疗,观察两组患者临床疗效、不孕症疗效、妊娠时段、妊娠情况、不良反应发生率等指标。结果 LSF组有效率为76.47%,Gn RH-a组有效率为82.35%,两组相比差异无统计学意义(P>0.05)。LSF组患者中未见明显不良反应,Gn RH-a组的不良反应发生率为23.52%,两组比较差异有统计学意义(P<0.05)。治疗后的3个月内,LST组复发率为17.65%,Gn RH-a组复发率为5.88%,差异有统计学意义(P<0.05)。与未妊娠组相比,妊娠组患者LF、EFI评分均较高,r-AFS较低,差异有统计学意义(P<0.05)。且r-AFS、LF、EFI两两之间呈显著的正相关关系(均r>0.3,P<0.05)。结论罗氏内异方与Gn RH-a在短期疗效、提高妊娠率、改善症状方面效果相当,但罗氏内异方在缩短术后妊娠时间,减少不良反应发生率方面优于Gn RH-a。

Objective To explore the value of laparoscopy combined with Luo＇s internal prescription in the treatment of severe endometriosis.Methods From January 2015 to May 2016,34 patients with moderate or severe endometriosis were divided into LSF group and Gn RH-a group with 17 in each.Two groups of patients were treated after laparoscopic conservative surgery,the LSF group was given the treatment of Luo＇s internal prescription,and group Gn RH-a was given subcutaneous injection of nered.The clinical efficacy,the effect of infertility,the pregnancy period,pregnancy,the incidence of adverse reactions were observed in the two groups.Results The effective rate of group LSF was 76.47%,and the effective rate of group Gn RH-a was 82.35%.There was no significant difference between the two groups（P〉 0.05）.There were no obvious adverse reactions in group LSF,and the incidence of adverse reactions in group Gn RH-a was 23.52%,the difference between the two groups was statistically significant（ P〈0.05）.Within 3 months after treatment,the recurrence rate of LST group was 17.65%,the recurrence rate of Gn RH-a group was 5.88%,the difference was statistically significant（P〈0.05）.Compared with the non-pregnant group,the LF and EFI scores were higher in the pregnant group and the r-AFS was lower,the difference was statistically significant（P〈0.05）.There was a significant positive correlation between r-AFS,LF and EFI（all r0.3,P〈0.05）.Conclusion The effect of Luo＇s internal prescription and Gn RH-a on short-term curative effect,increase of pregnancy rate and improvement of symptoms is equal,but Luo＇s internal prescription is superior to Gn RH-a in shortening the postoperative pregnancy time and reducing the incidence of adverse reactions.