腹腔镜手术联合促性腺激素释放激素激动剂治疗Ⅰ-Ⅱ期子宫内膜异位症伴不孕临床疗效

Laparoscopic surgery combined gonadotropin-releasing hormone agonist treatment Ⅰ-Ⅱ period clinical curative effect of endometriosis associated with infertility

目的:探讨腹腔镜手术(LS)联合促性腺激素释放激素激动剂(Gn RH-a)治疗Ⅰ-Ⅱ期子宫内膜异位症(EMT)伴不孕的临床疗效。方法:根据治疗方案将245例Ⅰ-Ⅱ期EMT伴不孕症患者作为研究对象,其中A组患者(85例)接受LS联合醋酸曲普瑞林注射液治疗,B组患者(82例)接受LS联合复方炔诺酮片治疗,C组患者(88例)仅接受LS治疗,现对比分析这3组患者的治疗效果。结果:(1)三组患者手术时间、术中出血量、术后下床活动时间、术后肛门排气时间、术后住院时间相比差异有统计学意义,A组患者上述5个指标显著低于B组与C组,B组患者上述5个指标显著低于C组。(2)手术前,三组患者VAS评分相比差异无统计学意义。术后12个月,三组患者VAS评分相比差异有统计学意义,A组患者VAS评分显著低于B组与C组,B组患者VAS评分显著低于C组。(3)术后随访12个月,三组患者复发率相比差异有统计学意义,A组患者复发率显著低于B组与C组,B组患者复发率显著低于C组。(4)术后随访18个月,三组患者自然妊娠率相比差异有统计学意义,A组患者自然妊娠率显著高于B组与C组,B组患者自然妊娠率显著高于C组。结论:LS联合Gn RH-a治疗Ⅰ-Ⅱ期EMT伴不孕症的疗效确切,具有手术创伤小,术后恢复快、痛感轻,复发率低,自然妊娠率高等诸多优点。

Objective To study the laparoscopic surgery(LS) joint gonadotropin-releasing hormone agonist treatment(Gn RH-a) Ⅰ-Ⅱ phase of endometriosis(EMT) associated with the clinical curative effect of infertility.Methods According to the treatment to 245 cases of Ⅰ-phase Ⅱ EMT infertility patients as the research object,in which A group of patients(85cases) to accept the LS joint acetic acid Qu Pu gonadorelin injection treatment,B group of patients(82 cases) to accept the LS joint compound norethindrone treatment,patients of group C(88 cases) treated with LS only,contrast analysis of the therapeutic effect of the three groups of patients.Results(1) Three groups of patients with operation time,intraoperative blood loss,postoperative bed time,postoperative anal exhaust time,postoperative hospital stay compared with the difference was statistically significant,A group of patients with the above five indexes significantly lower than that of group B and C group,the above five indexes group B patients significantly lower than that of group C.(2) before the operation,the three groups of patients compared VAS score there was no statistically significant difference.12 months postoperatively,three groups of patients compared VAS score difference was statistically significant,A group of patients VAS score significantly lower than that of group B and C group,group B patients VAS score was significantly lower than that of group C.(3) postoperative follow-up of 12 months,three groups of patients with recurrence rate than the difference was statistically significant,A group of patients with recurrence rate was significantly lower than that of group B and C group,group B patients with recurrence rate was significantly lower than that of group C.(4) postoperative follow-up of 18 months,three groups of patients compared to natural pregnancy rate difference was statistically significant,A group of patients with natural pregnancy rate is significantly higher than group B and group C,group B patients natural pregnancy rate is significantly higher than group C.Conclusion LS Ⅰ-Ⅱ joint Gn RH-a treatment period of EMT associated with infertility efficacy,with a small surgical trauma,quick recovery,the pain is light,the recurrence rate is low,natural pregnancy rates higher advantages.