腹腔镜手术联合GnRHa对卵巢巧克力囊肿伴不孕患者血清激素水平及妊娠情况的影响

Effects of laparoscopic surgery combined with GnRHa on serum hormone levels and pregnancy in patients with ovarian chocolate cysts and infertility

目的探讨腹腔镜手术联合促性腺激素释放激素激动剂(GnRHa)治疗卵巢巧克力囊肿伴不孕患者的临床疗效,以及对患者血清性激素水平及妊娠情况的影响。方法选择2016年1月~2018年6月在我院治疗的114例卵巢巧克力囊肿伴不孕患者,随机分为对照组和观察组,每组57例。对照组患者采用腹腔镜手术治疗,观察组患者在腹腔镜术后给予GnRHa,比较两组患者的治疗有效率及治疗前后的血清卵泡刺激(FSH)、黄体生成激素(LH)及雌二醇(E2)水平;随访期间两组患者的妊娠情况、复发率及不良反应。结果观察组患者治疗有效率为96.49%明显高于对照组的84.21%(P<0.05);治疗后,观察组患者的FSH、LH及E2水平水平均明显低于对照组(P<0.05);随访12个月,观察组患者的妊娠率68.42%明显高于对照组的42.11%(P<0.05);观察组患者的复发率5.26%明显低于对照组的19.30%(P<0.05);观察组患者在用药过程中不良反应症状轻微,均可耐受。结论腹腔镜手术联合GnRHa能够有效改善卵巢巧克力囊肿合并不孕患者的卵巢功能,提高妊娠率,降低复发率,疗效显著,不良反应轻微,安全性高。

Objective To explore the clinical efficacy of laparoscopic surgery combined with gonadotropin-releasing hormone agonist(GnRHa)in the treatment of ovarian chocolate cysts with infertility,and its influence on serum sex hormone levels and pregnancy status.Methods 114 patients with ovarian chocolate cysts and infertility treated in our hospital from January 2016 to June 2018 were randomly divided into a control group and an observation group,with 57 cases in each group.The control group was treated with laparoscopic surgery,while the observation group was given GnRHa after laparoscopic surgery.The treatment efficiency and follicle-stimulating hormone(FSH),luteinizing hormone(LH),and estradiol(E2)level before and after treatment were compared between the two groups;Pregnancy status,recurrence rate,and adverse reactions in the two groups during the follow-up period were observed and compared.Results The effective rate of treatment in the observation group was 96.49%,which was significantly higher than 84.21%in the control group(P<0.05).After treatment,the levels of FSH,LH and E2 in the observation group were significantly lower than those in the control group(P<0.05);During a 12-month follow-up,the pregnancy rate of the observation group(68.42%)was significantly higher than that of the control group(42.11%)(P<0.05).The recurrence rate of the observation group was 5.26%,which was significantly lower than 19.30%of the control group(P<0.05);Patients in the observation group had mild symptoms of adverse reactions during medication and were all tolerable.Conclusion Laparoscopic surgery combined with GnRHa can effectively improve the ovarian function,increase the pregnancy rate,and reduce the recurrence rate in patients with ovarian chocolate cysts and infertility.It has remarkable effects,mild adverse reactions and high safety.