GnRH-a和口服避孕药联合微创手术治疗重度子宫内膜异位症患者的疗效分析

Effect Analysis of GnRH-a and Oral Contraceptive Combined with Minimally Invasive Surgery in Patients with Severe Endometriosis

目的:为进一步明确GnRH-a和口服避孕药联合微创手术治疗重度子宫内膜异位症患者的疗效。方法:选取2014年1月-2016年12月本院收治重度子宫内膜异位症患者159例,按照随机数字表法将其分为对照组、GnRH-a组和口服避孕药组,每组各53例。三组均行腹腔镜子宫内膜异位症保守性手术,GnRH-a组和口服避孕药组在此基础上分别给予亮丙瑞林和复方炔诺酮片治疗。比较三组基线期及治疗后血清E_2、FSH及LH水平,观察治疗期间不良反应发生率及术后12个月内的疾病复发率。结果:治疗后,血清E_2、FSH及LH水平均以对照组最高、口服避孕药组其次、GnRH-a组最低,比较差异均有统计学意义(P<0.05)。结论:GnRH-a较口服避孕药辅助保守性手术治疗EMS效果更佳,但有引发围绝经期综合征的风险。

Objective:To further clear the effect of GnRH-a and oral contraceptive combined with minimally invasive surgery in patients with severe endometriosis.Method:A total of 159 patients with severe endometriosis treated from January 2014 to December 2016 in our hospital were selected.According to the random number table method,they were divided into control group,GnRH-a group and oral contraceptive group,53 cases in each group.All three groups were treated with conservative laparoscopic endometrial surgery.The GnRH-a group and oral contraceptive group were received Leuprorelin and Compound Norethisterone Tablets treatment respectively.The levels of serum E2,FSH and LH at baseline and after treatment were compared,the incidence of adverse reactions during treatment and the recurrence rate within 12 months after operation were observed among the three groups.Result:After treatment,the levels of serum E2,FSH and LH were the highest in the control group,the second of the oral contraceptive group and the lowest in the GnRH-a group,the differences were statistically significant(P<0.05).Conclusion:GnRH-a is better than oral contraceptive assisted conservative surgery in the treatment of EMS,but there is a risk of perimenopausal syndrome.