戈舍瑞林与米非司酮在腹腔镜手术治疗巧克力囊肿中的应用效果

Effect of Goserelin and Mifepristone in treatment of chocolate cyst by laparoscopy

目的对比观察戈舍瑞林与米非司酮在腹腔镜术后治疗巧克力囊肿的效果。方法将2013年3月~2015年3月在我院接受治疗的88例巧克力囊肿患者随机分为戈舍瑞林组和米非司酮组,各44例。两组均接受腹腔镜下卵巢囊肿剔除术治疗;戈舍瑞林组术后给予戈舍瑞林治疗,米非司酮组术后给予米非司酮治疗。比较两组治疗前后体内血清促卵泡激素(FSH)、促黄体素(LH)及雌二醇(E2)水平变化,临床效果,临床症状改善情况,不孕率,复发率和妊娠率。结果两组治疗前后FSH和LH在血清中的表达水平比较,差异均无统计学意义(P>0.05)。两组治疗前E2在血清中表达水平差异无统计学意义(P>0.05),治疗后戈舍瑞林组E2在血清中的表达水平明显低于米非司酮组(P<0.05)。两组治疗后性交痛、痛经的临床症状基本都有改善,但改善情况差异无统计学意义(P>0.05)。两组在治疗前不孕率差异无统计学意义(P>0.05)。戈舍瑞林组治疗总有效率为90.9%,复发率为11.4%,妊娠率为62.5%,而米非司酮组分别为77.3、27.3%、43.5%,差异均有统计学意义(P<0.05)。结论腹腔镜术后联合应用戈舍瑞林治疗巧克力囊肿临床效果显著,术后患者复发率低,有临床推广价值。

Objective To explore the clinical effect of laparoscopic surgery combined with Goserelin and Mifepristonein treatment of chocolate cyst of the ovary.Methods From March 2013 to March 2015,88 patients with chocolate cyst were randomly divided into Goserelin group and Mifepristone group,44 cases in each group.All the cases in the two groups were treated by laparoscopic surgery,then the patients in Goserelin group were treated by Gestrinone,the patients in Mifepristone group were treated by Mifepristone.The serum levels of follicle stimulating hormone（FSH）,luteinizing hormone（LH） and estradiol（E2） before and after therapy,the clinical effects,symptom improvement,infertility rate,recurrence rates,and pregnancy rates of the two groups were compared.Results There was no statistically significant difference in the levels of serum FSH,LH before and after treatment between the two groups（P〉0.05）.There was no statistically significant difference in the levels of serum E2 before treatment,but the levels of serum E2 level in Goserelin group was statistically significantly lower than that in Mifepristone group（P〈0.05）,after treatment,the clinical symptoms such as algopareunia and dysmenorrhea improved obviously after treatment in the two groups,but there was no statistically significant difference in the improvement between the two groups.There was no significant difference in the infertility rate between the two groups before treatment（P 〉0.05）.The total effective rates,recurrence rates,and pregnancy rates were90.9%,11.4%,62.5% in Goserelin group and 77.3%,27.3%,43.5% in Mifepristone group,respectively,there were statistically significant differences between the two groups（P〈0.05）.Conclusion There are so many advantages to treat chocolate cyst with laparoscopic surgery combined with Goserelin,such as significant clinical effect and low recurrence rate.It is worthy for extending in clinic.