子宫内膜异位症经腹腔镜手术联合GnRH-a治疗的临床应用效果观察

Observation on clinical effect of laparoscopic surgery combined with GnRH-a in treatment of endometriosis

目的探究腹腔镜手术联合促性腺激素释放激素激动剂(GnRH-a)治疗子宫内膜异位症的临床效果。方法选取2013年2月-2015年3月在该院妇科行腹腔镜手术并经病理活检诊断确诊为子宫内膜异位症的患者72例,其中合并不孕症患者16例,根据患者治疗意愿将其分为对照组和观察组,各36例。观察组实施腹腔镜手术联合GnRH-a治疗,术后第3天开始给予3.75 mg GnRH-a皮下注射,每28天注射一次,注射6次对照组单纯采用腹腔镜手术治疗,术后定期随访,未作其他处理。观察对比两组术后1年内疗效、术后复发率及妊娠率。结果观察组疗效有效率(94.4%)明显高于对照组(66.7%),差异有统计学意义(P<0.05);观察组复发率(19.4%)明显高于对照组(2.8%),妊娠率(25.0%)低于对照组(62.5%),差异均有统计学意义(均P<0.05)。结论子宫内膜异位症患者采用腹腔镜手术联合GnRH-a治疗,可提高疗效及妊娠率,降低复发率,缩短月经及排卵恢复时间。

Objective To explore the clinical efficacy of laparoscopic surgery combined with gonadotropin-releasing hormone agonist(GnRH-a) in treatment of endometriosis.Methods From February 2013 to March 2015,72 patients diagnosed as endometriosis definitely by pathological biopsy after laparoscopic surgery in Department of Gynecology were selected,including 16 patients with infertility.All the patients were divided into control group and observation group according to the patient’s treatment intention,36 patients in each group.The patients in observation group were treated by laparoscopic surgery combined with subcutaneous injection of GnRH-a(3.75 mg),GnRH-a was applied every 28 days from the third day after laparoscopic surgery for 6 times.The patients in control group were treated by laparoscopic surgery,then regular follow-up was performed after laparoscopic surgery.The curative effects,postoperative recurrence rates,and pregnancy rates within one year after laparoscopic surgery were observed and compared between the two groups.Results The effective rate in observation group was 94.4%,which was statistically significantly higher than that in control group(66.7%)(P<0.05).The recurrence rate in observation group was 19.4%,which was statistically significantly higher than that in control group(2.8%)(P< 0.05).The pregnancy rate in observation group was 25.0%,which was statistically significantly lower than that in control group(62.5%)(P<0.05).Conclusion Laparoscopic surgery combined with GnRH-a can improve clinical effect and pregnancy rate,reduce recurrence rate,and shorten menstrual cycle and recovery time of ovulation in treatment of patients with endometriosis.