腹腔镜囊肿剥除术联合GnRH-a对卵巢子宫内膜异位囊肿患者卵巢功能的影响

Effect of laparoscopic cystectomy combined with GnRH-a on ovarian function in patients with ovarian endometrisis cyst

目的探讨腹腔镜囊肿剥除术联合促性腺激素释放激素激动剂(GnRH-a)对卵巢子宫内膜异位囊肿患者卵巢功能的影响。方法选取2018年1月至2020年6月在我院接受治疗的120例卵巢子宫内膜异位囊肿患者作为研究对象,根据治疗方案的不同将其分为对照组和观察组,各60例。对照组给予腹腔镜剥除术治疗,观察组在对照组基础上给予GnRH-a治疗。比较两组的卵巢功能相关指标、血清生化因子、临床疗效、复发率及生活质量。结果治疗后,两组的雌二醇(E2)、卵泡生成激素(FSH)、黄体生成激素(LH)水平均低于治疗前,且观察组低于对照组(P<0.05)。治疗后,两组的调节活化正常T细胞表达与分泌因子(RANTES)、高迁移率族蛋白B1(HMGB1)、糖类抗原125(CA125)、基质金属蛋白酶-9(MMP-9)水平均低于治疗前,1,25-二羟维生素D3[1,25(OH)2D3]水平高于治疗前,且观察组优于对照组(P<0.05)。观察组的治疗总有效率高于对照组,复发率低于对照组(P<0.05)。治疗后,两组的简明健康状况调查表(SF-36)各维度评分均高于治疗前,且观察组高于对照组(P<0.05)。结论腹腔镜囊肿剥除术联合GnRH-a治疗能有效提高卵巢子宫内膜异位囊肿患者的卵巢功能,调节相关血清生化因子,降低术后复发率,提高疗效及生活质量。

Objective To investigate the effect of laparoscopic cystectomy combined with gonadotropin releasing hormone agonist(GnRH-a)on ovarian function in patients with ovarian endometrisis cyst.Methods A total of 120 patients with ovarian endometriosis cyst who were treated in our hospital from January 2018 to June 2020 were selected as the research objects.According to different treatment schemes,the patients were divided into control group and observation group,with 60 cases in each group.The control group was treated with laparoscopic cystectomy,and the observation group was treated with GnRH-a on the basis of the control group.The ovarian function related indexes,serum biochemical factors,clinical efficacy,recurrence rate and quality of life were compared between the two groups.Results After treatment,the levels of estradiol(E2),follicle stimulating hormone(FSH)and luteinizing hormone(LH)in the two groups were lower than those before treatment,and those in the observation group were lower than the control group(P<0.05).After treatment,the levels of regulated upon activation normal T-cell expressed and secreted(RANTES),high-mobility group box 1(HMGB1),carbohydrate antigen 125(CA125)and matrix metalloproteinase-9(MMP-9)in the two groups were lower than those before treatment,the level of 1,25-dihydroxyvitamin D3[1,25(OH)2D3]was higher than that before treatment,and those in the observation group were better than the control group(P<0.05).The total effective rate of treatment in the observation group was higher than that in the control group,and the recurrence rate was lower than that in the control group(P<0.05).After treatment,the scores of each dimension of 36-Item Short-Form Health Survey(SF-36)in the two groups were higher than those before treatment,and those in the observation group were higher than the control group(P<0.05).Conclusion Laparoscopic cystectomy combined with GnRH-a treatment can effectively improve the ovarian function of patients with ovarian endometrisis cyst,regulate the related serum biochemical factors,reduce the recurrence rate,and improve the curative effect and quality of life.