子宫内膜异位症术后应用不同治疗周期半剂量促性腺激素释放激素激动剂的疗效观察

探讨1．875mg促性腺激素释放激素激动剂（GnRH—a）不同治疗周期对子宫内膜异位症术后的疗效。分析2010年1月至2011年6月行保守性腹腔镜手术且手术证实为盆腔子宫内膜异位症患者108例，其中术后应用半剂量GnRH—a治疗3个月的患者57例（A组），治疗6个月的患者51例（B组），比较两组间的临床有效率及停药后复发率和妊娠率。A、B组的临床有效率分别为73．7％（42／57）、90．2％（46／51），差异有统计学意义（P〈0．05），两组的复发率分别为14．O％（8／57）、5．9％（3／51），两组的妊娠率分别为45．0％（18／40）、4／12，差异无统计学意义（P〉0．05）。术后应用6个周期GnRH—a可提高临床有效率，降低及延迟盆腔子宫内膜异位症的复发；对于有生育要求的，可考虑减少GnRH—a的治疗周期后积极妊娠。

Uses of half-dose gonadotropin-releasing hormone agonist with different treatment cycles after conservative laparoscopic surgery in the treatment of endometriosis

To explore the efficacy of using gonadotropin-releasing hormone agonist （GnRH-a） with different cycles after conservative laparoscopic surgery in the treatment of endometriosis. Research was conducted on 108 patients with endometriosis III or IV diagnosed by conservative laparoscopy from January 2010 to June 2011. Among them, 57 patients （group A） were managed with GnRH-a postoperatively for 3 mouths and the others （group B ） 6 months. Clinical efficacy, relapse rate and pregnancy rate after withdrawal were compared between two groups. The clinical efficacy rate of groups A and B were 73.7% and 90. 2% respectively. And there were significant statistical differences between them. However, the relapse rate of groups A and B were 14. 0% and 5.9% and the pregnancy rate of two groups 45.0% and 4/12 respectively. And there were no statistical differences. A 6-month regimen of GnRH-a can reduce and delay the recurrence of endometriosis and improve the clinical efficacy. A short-term dosing of GnRH-a is indicated for those patients with fertility requirements.