腹腔镜手术联合药物治疗子宫内膜异位症117例临床分析

【目的】探讨腹腔镜手术联合孕三烯酮或促性腺激素激动剂（GnRH—a）治疗子宫内膜异位（内异症）的临床疗效。【方法】对117例内异症患者进行腹腔镜手术治疗，术后随机分为孕三烯酮组、GnRH—a组和对照组，比较三组的症状缓解率、妊娠率、术后复发率及药物副反应等情况。【结果】孕三烯酮组和GnRH—a组的症状缓解率、妊娠率均较对照组明显提高，复发率明显降低；孕三烯酮组常见的副反应有肝功能损害、阴道出血、痤疮、体重增加等，而GnRH—a组常见副反应主要为绝经期症状。【结论】腹腔镜手术联合药物孕三烯酮或GnRH—a治疗内异症对提高症状缓解率、妊娠率及降低复发率有重要的作用，但两种药物均有一定的副作用，常见的有肝功能损害、阴道出血及绝经期症状等。

Clinical Analysis on Laparoscopic Operation Combined with Medication for the Treatment of 117 Cases of Endometriosis

Objective]To study the clinical efficacy of laparoscopic operation combined with gestrinone or GnRH-a for the treatment of endometriosis. Methods] A total of 117 patients with endometriosis were treated by laparoscopy. After treatment, they were divided into gestrinone group, GnRH-a group and control group. Remission rate, pregnancy outcome, relapse rate and drug side effect among three groups were compared. Results] Compared with the control group, the remission rate and pregnancy outcome increased and the relapse rate decreased obviously in gestrinone group and GnRH-a group. The common side effects in gestrinone were liver damage, vaginal bleeding, acne, and weight gain, etc. And the common side effects in GnRH-a group mainly were menopausal symptoms. Conclusion]Laparoscopic operation combined with gestri- none or GnRH-a for the treatment of endometriosis has an important role in increasing the remission rate and pregnancy rate and decreasing the relapse rate. But the two drugs have common side effects such as liver damage, vaginal bleeding and menopausal symptoms, etc.