腹腔镜手术分别联合GnRH-a与孕三烯酮治疗子宫内膜异位症的效果比较

目的比较腹腔镜手术分别联合GnRH-a与孕三烯酮治疗子宫内膜异位症(EMS)的临床效果,探讨腹腔镜术后联合药物治疗EMS的最佳方案。方法选择80例EMS患者,将之均分为孕三烯酮组(40例)和GnRH-a组(40例),在腹腔镜手术后分别给予孕三烯酮和GnRH-a治疗,比较两组患者治疗前后生殖激素水平、治疗期间不良反应情况及治疗1年后临床疗效。结果治疗后GnRH-a组血清LH、FSH和E2水平显著低于孕三烯酮组(P<0.05),血清PRL水平比较差异无统计学意义(P>0.05);两组患者药物治疗过程中出现的不良反应例数比较,差异无统计学意义(P>0.05),出现的不良反应均无需特殊处理;治疗1年后,GnRH-a组临床疗效优于孕三烯酮组,组间缓解例数比较差异有统计学意义(P<0.05),改善、无效与复发例数比较,差异均无统计学意义(P>0.05)。结论腹腔镜手术治疗EMS后应联合药物治疗,应首选GnRH-a药物治疗,可显著提高临床疗效,减少术后复发,同时未增加不良反应患者例数。

Comparison of laparoscopic surgery combined GnRH-a or gestrinone in the treat-ment of endometriosis

Objective To compare the clinical effect of laparoscopic surgery combined GnRH-a or gestrinone in the treatment of endometriosis and explore the best programs to treat the endometriosis. Methods 80 patients with endometriosis were selected and divided into GnRH-a group （ n = 40） and gestrinone group （ n = 40） , the reproductive hormone levels before and after treatment, the adverse reactions during treatment and the clinical effect after one year＇s treatment of the two groups were compared. Results The level of serum LH, FSH and E2 in the GnRH-a group were lower than that in the gestrinone group after treatment （ P 〈 0. 05 ） , there was no significant difference in the level of se- rum PRL after treatment （ P 〉 0. 05 ） ; there was no significant difference in the number of adverse reactions during treatment （ P 〉 0. 05 ） ; the number of alleviate in the GnRH-a group was higher than that in the gestrinone group after one year＇s treatment （P 〈 0. 05 ）, there was no significant difference in the number of improvement, invalid and recur- rence after one year＇s treatment （ P 〉 0. 05 ）. Conclusion When treating the endometriosis with laparoscopic surgery combine with drug treatment, we should choose the GnRH-a first, it could significantly improve the clinical effect and do not increase the number of adverse reactions.