腹腔镜卵巢子宫内膜异位囊肿剥除术后不同管理方式对囊肿复发及妊娠结局影响的临床研究

Clinical study on the effect of different management methods on the recurrence of ovarian endometriosis cyst after laparoscopic removal and pregnancy outcome

目的探讨腹腔镜卵巢子宫内膜异位囊肿剥除术后不同管理方式对囊肿复发及妊娠结局的影响。方法选取152例接受卵巢子宫内膜异位囊肿剥除术的患者,按照术后管理方法不同分为无管理组(51例)、GnRH-a组(67例)、曼月乐环组(15例)和药物治疗组(19例),对比四组术后囊肿复发情况及妊娠结局。结果腹腔镜卵巢子宫内膜异位囊肿术后5年内总复发率为19.74%,无管理组、GnRH-a组、曼月乐环组及口服药物治疗组术后5年内总复发率及妊娠率分别为7.84%/15.79%、28.36%/24.34%、33.33%/1.32%及10.53%/3.95%,各组间指标比较差异均有统计学意义(P<0.05)。结论腹腔镜卵巢子宫内膜异位囊肿剥除术后较易复发,术后采用GnRH-a治疗可获得最大的妊娠获益。

Objective To investigate the effects of different management methods on cyst recurrence and pregnancy outcomes after laparoscopic ovarian endometriosis cyst removal.Methods 152 patients with ovarian endometriosis cyst removal were selected and divided into two groups according to different postoperative management methods:no management group(51 cases),GnRH-a group(67 cases),mirenacin group(15 cases)and oral drug treatment group(19 cases).The recurrence of postoperative cysts and pregnancy outcomes of the four groups were compared.Results The total recurrence rate within 5 years after laparoscopic ovarian endometrial cyst was 19.74%.The total recurrence rate and pregnancy rate within 5 years after surgery were 7.84%/15.79%,28.36%/24.34%,33.33%/1.32%and 10.53%/3.95%in the no-management group,the GnRH-a group,the Mirenecril group and the oral drug treatment group,respectively,and there were statistically significant differences among all groups(P<0.05).Conclusion Laparoscopic ovarian endometriosis cyst removal is more likely to recur,Postoperative treatment with GnRH-a maximizes pregnancy benefit.