孕三烯酮联合腹腔镜治疗子宫内膜异位症对生育功能影响

Effect of gestrinone combined with laparoscopy on reproductive function in patients with endometriosis

目的探讨孕三烯酮联合腹腔镜治疗子宫内膜异位症对生育功能的影响。方法选取2015年8月至2018年10月我院收治的子宫内膜异位症患者86例为研究对象,随机分为研究组与对照组。对照组患者单纯进行腹腔镜治疗,研究组患者经腹腔镜治疗结束后应用孕三烯酮。治疗结束后对2组患者进行随访,对比2组患者临床疗效、治疗前后生殖激素水平、术后1年妊娠成功率、复发率及排卵恢复时间,并观察2组患者不良反应。结果研究组患者的临床总有效率(91%)明显高于对照组(72%);治疗前,2组患者生殖激素水平对比差异无统计学意义(P>0.05),治疗6个月后,2组患者的催乳素(PRL)、雌二醇(E_(2))、黄体生成素(LH)、卵泡刺激素(FSH)水平均较治疗前明显降低,且研究组患者的PRL、E_(2)、LH、FSH水平显著低于对照组(P<0.05);研究组患者妊娠率显著高于对照组,复发率显著低于对照组,排卵恢复时间较对照组显著缩短(P<0.05);研究组患者不良反应总发生率显著低于对照组(P<0.05)。结论孕三烯酮联合腹腔镜治疗子宫内膜异位症能够有效提高临床疗效,改善患者生殖激素水平,降低不良反应发生,值得临床推广。

Objective To investigate the effect of gestrinone combined with laparoscopy on reproductive function in patients with endometriosis.Methods Eighty-six patients with endometriosis admitted to our hospital between August 2015 and October 2019 were included as the subjects in the study,and all patients were randomly divided into the study group and control group.The control group received laparoscopic treatment alone,and the study group was treated with gestrinone after laparoscopic treatment.After the treatment,the two groups were followed up.The clinical efficacy,reproductive hormone level at baseline and after the treatment,pregnancy success rate at 1 year after the operation,recurrence rate,and time to ovulation recovery were compared between the two groups,and the adverse reactions in the two groups were examined.Results The total clinical effective rate in the study group was significantly higher than that in the control group(91%vs 72%).There was no significant difference in the reproductive hormone level between the two groups at baseline(P>0.05).At 6 months after the treatment,the PRL,E_(2),LH and FSH levels in the two groups significantly decreased compared with those at baseline.The PRL,E_(2),LH and FSH levels in the study group were significantly lower than those in the control group(all P<0.05).The pregnancy success rate in the study group was significantly higher than that in the control group,the recurrence rate was significantly lower than that in the control group,and the time to ovulation recovery was significantly shorter than that in the control group(all P<0.05).The total incidence of adverse reactions in the study group was significantly lower than that in the control group(P<0.05).Conclusion The combination of gestrinone and laparoscopy in the treatment of endometriosis may effectively improve the clinical efficacy,improve the reproductive hormone level and reduce the occurrence of adverse reactions,and therefore is worthwhile of widespread use in the clinical pratices.