腹腔镜联合药物治疗卵巢子宫内膜异位囊肿的体会

目的:观察腹腔镜联合药物治疗卵巢子宫内膜异位囊肿的临床疗效。方法:选取90例卵巢子宫内膜异位囊肿患者并随机分为两组,45例患者采用单纯腹腔镜手术作为对照组,45例患者采用腹腔镜手术联合药物治疗作为观察组,术后随访患者2年,观察两组患者临床疗效、不孕患者的受孕率,同时对观察组患者用药期间不良反应发生情况进行观察。结果:观察组治疗总有效率为88.88%,对照组为66.66%,观察组显著高于对照组;观察组20例不孕症患者随访2年内14例(70.00%)受孕,对照组19例不孕症患者随访2年内6例(31.58%)受孕,观察组显著高于对照组,差异均有统计学意义(P<0.05)。观察组口服米非司酮的25例患者中,2例表现为肝酶升高,20例口服孕三烯酮的患者,3例发生肝损害,停药或配合护肝治疗后症状消失,其他患者表现为乏力,恶心等轻微不良反应,均在停药后症状消失。结论:腹腔镜联合药物治疗卵巢子宫内膜异位囊肿可提高治疗效果,提高不孕患者受孕率,而且不良反应轻微,可作为患者腹腔镜手术后的辅助治疗。

Laparoscopy combined with medication in the treatment of ovarian endometriotic cysts

Objectives: To observe the clinical efficacy of laparoscopy combined with medication in the treatment of ovarian endometrial cysts.Methods: A total of 90 patients with ovarian endometriosis cysts were randomly divided into two groups: 45 cases in the control group were treated only with laparoscopic surgery;45 cases in the experiment group were treated by laparoscopic surgery combined with medication treatment.Patients were followed up for 2 years to observe the clinical efficacy,the pregnancy rate of infertile patients and the adverse events.Results: The overall efficiency in the experiment group and the control group were 88.88% and 66.66% respectively with significantly higher rate in the experiment group;Twenty infertility patients in the experiment group were followed for 2 years,indicating 14 cases of pregnancy(70%),while the follow-up study on 19 patients in the control indicated 6 cases of pregnancy(31.58%).The experiment group showed significantly higher pregnancy rate than the control(P<0.05).In the 25 patients of the experiment group treated with mifepristone,2 patients showed elevated liver enzymes,20 patients treated with oral administration of gestrinone,3 cases showed liver damage.The symptoms disappeared after medication withdrawal or corresponding treatment.Other patients presented with minor adverse effects of fatigue,nausea.All symptoms disappeared after drug discontinuation.Conclusion: Laparoscopy combined medication can improve the therapeutic effects in the treatment of ovarian endometrial cysts.It can enhance pregnancy rate,yet present little adverse reactions.Therefore,it can be used as adjuvant therapy after laparoscopic surgery.