腹腔镜联合不同治疗方案在子宫内膜异位症中的临床应用价值研究

Study on the Clinical Application Value of Laparoscopy Combined with Different Treatment Regimens in Endometriosis

目的:探究腹腔镜联合不同治疗方案在卵巢型子宫内膜异位症(EMS)中的临床应用效果及对血清指标的影响。方法:选择2018年6月-2019年1月阳江市阳东区人民医院妇产科收治的60例卵巢型EMS患者作为研究对象,将其按随机数字表法分为对照组与观察组,各30例。对照组采用腹腔镜联合促性腺激素释放激素激动剂(GnRH-a)治疗,观察组采用腹腔镜联合左炔诺孕酮宫内缓释系统(LNG-IUS)治疗,随访1年,观察两组临床治疗效果、血清指标变化、不良反应情况、VAS评分及生活质量。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05);治疗6个月后,观察组CA72-4、CA125、HE4、E2、LH、FSH水平均低于对照组,AMH水平高于对照组,差异均有统计学意义(P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05);治疗3、6个月及治疗后12个月观察组VAS评分均低于对照组,差异均有统计学意义(P<0.05);治疗后12个月观察组FSFI评分高于对照组,差异有统计学意义(P<0.05)。结论:腹腔镜联合LNG-IUS治疗卵巢型EMS效果显著,不良反应少,可明显改善患者血清指标,降低疼痛评分,提升性生活质量。

Objective:To explore the clinical application effect of laparoscopy combined with different treatment regimens in ovarian endometriosis (EMS) and its influence on serum indexes.Method:A total of 60 patients with ovarian EMS admitted to the Department of Obstetrics and Gynecology of Yangdong District People’s Hospital of Yangjiang City from June 2018 to January 2019 were selected as the subjects of this study.According to the random number table method,they were divided into the control group and the observation group,with 30 patients in each group.The control group was treated with laparoscopy combined with gonadotropin releasing hormone agonist (GnRH-a),while the observation group was treated with laparoscopy combined with 1evonorgestrel-releasing intrauterine systems (LNG-IUS).The patients were followed up for 1 year to observe the clinical treatment effect,serum index changes,adverse reactions,VAS score and quality of life of the two groups.Result:The total effective rate in the observation group was higher than that in the control group,the difference was statistically significant (P<0.05).After 6 months of treatment,CA72-4,CA125,HE4,E2,LH,FSH levels in the observation group were lower than those in the control group,and AMH level was higher than that in the control group,the differences were statistically significant (P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).The VAS scores in the observation group were lower than those in the control group after 3,6 months of treatment and 12 months after treatment,the differences were statistically significant (P<0.05),12 months after treatment,the FSFI score in the observation group was higher than that in the control group,the difference was statistically significant (P<0.05).Conclusion:Laparoscopy combined with LNG-IUS has a significant effect on the treatment of ovarian EMS with few adverse reactions.It can significantly improve the serum indicators of patients,reduce pain score,and improve the quality of sexual life.