GnRH-a联合去氧孕烯炔雌醇辅助腹腔镜手术治疗子宫内膜异位症患者的疗效研究

Efficacy of GnRH-a and deoxypregnenyl estradiol combined with laparoscopic surgery in the treatment of endometriosis

目的探讨促性腺激素释放激素激动剂(GnRH-a)与去氧孕烯炔雌醇联合辅助腹腔镜手术治疗子宫内膜异位症(EM)的临床疗效。方法收集2015年1月至2016年12月古浪县人民医院就诊的重度子宫内膜异位症患者142例,均进行腹腔镜手术治疗,随机分为实验组(n=70)术后给予GnRH-a与去氧孕烯炔雌醇治疗,对照组(n=72)仅给予去氧孕烯炔雌醇。检测纳入实验患者的血清中内分泌激素水平,观察实验患者的复发、妊娠情况和不良反应,并进行统计分析。结果两组患者经过治疗术后1、6、12个月血清FSH、LH、E2激素水平逐渐降低,差异具有统计学意义(P<0.05);但实验组与对照组在各阶段检测的血清FSH、LH、E2激素水平未呈现显著差异(P>0.05)。实验组的复发率和妊娠率明显低于对照组,差异具有统计学意义(P<0.05)。实验组患者术后更年期症状及不良反应发生率低于对照组,差异具有统计学意义(P<0.05)。结论 GnRH-a与去氧孕烯炔雌醇联合用药可减轻子宫内膜异位症患者腹腔镜手术治疗后引起的更年期症状和不良反应,并能有效减少复发率,具有明确疗效。

Objective To explore the clinical efficacy of gonadotropin releasing hormone agonist(GnRH-a)and deoxypregnenyl estradiol combined with laparoscopy in the treatment of endometriosis(EM).Methods A total of 142 EM patients treated during Jan.2015 and Dec.2016 were randomly divided into the experimental group(n=70)and control group(n=70).The experimental group was treated with GnRH-a and deoxypregnenyl estradiol,while the control group was given deoxypregnenyl estradiol only.The serum levels of endocrine hormones,recurrence rate,pregnancy and adverse reactions of the two groups were observed and analyzed.Results The serum level of follicle-stimulating hormone(FSH),luteinizing hormone(LH)and estradiol(E 2)of the two groups gradually decreased over 1,6 and 12 months after treatment,and the differences were not statistically significant between the two groups(P>0.05).The recurrence rate and pregnancy rate in the experimental group were significantly lower than those in the control group(P<0.05).The incidence of postmenopausal symptoms and adverse reactions were lower in the experimental group than in the control group(P<0.05).Conclusion GnRH-a combined with deoxypregnenyl estradiol can reduce the climacteric symptoms and adverse reactions in patients with endometriosis after laparoscopic surgery,and can effectively reduce the recurrence rate.