腹腔镜联合GnRH-a及左炔诺孕酮宫内节育系统与单纯腹腔镜治疗卵巢巧克力囊肿的疗效对比分析

Comparative analysis of laparoscopic combined with GnRH-a and levonorgestrel intrauterine system in treatment of ovarian chocolate cyst with simple laparoscopy

目的比较腹腔镜联合促性腺激素释放激素激动剂(gonadotropin-releasing hormone-agonist,GnRH-a)及左炔诺孕酮宫内节育系统与单纯腹腔镜治疗卵巢巧克力囊肿的疗效。方法选取2011年2月至2014年12月就诊于安徽医科大学附属省立医院的58例卵巢巧克力囊肿患者为研究对象,按治疗方式不同将其分为对照组(单纯腹腔镜治疗)和观察组(腹腔镜+GnRH-a及左炔诺孕酮宫内节育系统治疗),每组各29例,比较两组患者的临床疗效及治疗前后性激素(黄体生成素、卵泡刺激素、雌二醇)水平变化情况。治疗后随访2年,统计两组患者的妊娠情况。结果观察组患者治疗总有效率显著高于对照组(P<0.05),复发率显著低于对照组(P<0.05)。治疗后,观察组患者黄体生成素、卵泡刺激素及雌二醇水平均显著低于对照组(P<0.05),总妊娠率显著高于对照组(P<0.05)。结论与单纯腹腔镜治疗相比,腹腔镜联合GnRH-a及左炔诺孕酮宫内节育系统治疗卵巢巧克力囊肿,有助于缓解患者临床症状,降低性激素水平,提高妊娠率。

Objective To compare the curative effect of laparoscopy combined with gonadotropin-releasing hormone-agonist(GnRH-a)and levonorgestrel intrauterine system and simple laparoscopic in the treatment of ovarian chocolate cyst.Method From February2011to December2014,58cases of patients with ovarian chocolate cyst treated in Anhui Provincial Medical University Affiliated Provincial Hospital were selected and divided into control group(simple laparoscopic treatment)and observation(Laparoscopic+GnRH-a and levonorgestrel intrauterine system),29patients in each group.The clinical efficacy and the change of sex hormone(luteinizing hormone,follicle-stimulating hormone,estradiol)levels before and after treatment were compared between the two groups.After2years of follow-up,pregnancy status of the two groups were compared.Result The total effective rate of observation group was significantly higher than that of control group(P<0.05),and the recurrence rate was significantly lower than that of control group(P<0.05).After treatment,the levels of luteinizing hormone,follicle-stimulating hormone,estradiol of observation group were significantly lower than those of control group(P<0.05),and the total pregnancy rate was significantly higher than that of control group(P<0.05).Conclusion Compared with simple laparoscopic treatment,laparoscopic combined with GnRH-a and levonorgestrel intrauterine system in the treatment of ovarian chocolate cyst,can help alleviate the clinical symptoms,reduce sex hormone levels,improve pregnancy rate.