微创手术联合GnRH-a治疗子宫内膜异位症的疗效和安全性研究

目的探讨微创手术联合促性腺激素激动剂(gonadotropin-releasing hormone-agonist,GnRH-a)治疗内异症的疗效及安全性。方法收集2010年2月~2012年2月来我院治疗的内异症患者80例,随机分为实验组与对照组,每组各40例。对照组使用腹腔镜手术后再用常规消炎药和口服避孕药治疗;实验组腹腔镜手术后在常规消炎药的基础上加用GnRH-a(反向添加法)治疗。然后比较两组患者的临床疗效及复发率。结果实验组有效率为85%(34/40),明显高于对照组45%(18/40),差异有统计学意义(P0.05)。实验组复发率7.5%(3/40),明显低于对照组32.5%(13/40),其差异有统计学意义(P0.05)。实验组与对照组有生育要求的患者分别为22例与23例,治疗后妊娠率实验组40.9%(9/22)高于对照组34.8%(8/23),但其差异无统计学意义(P0.05)。药物的不良反应,实验组10%(4/40)高于对照组,但其差异无统计学意义(P0.05)。结论微创手术联合GnRH-a治疗内异症安全且高效。

The Efficacy and Safety of Minimally Invasive Surgery Combined GnRH-a in the Treatment of Endometriosis

Objective To explore the efficacy and safety studies of minimally invasive surgery combined GnRH-a in the treatment of endometriosis. Methods 80 cases that came to our hospital from February 2010 to February 2012 with endometriosis were collected. All the patients were randomly divided into control group and experimental group. 40 cases of the control group received laparoscopic surgery and conventional anti-inflammatory drug and oral contraceptives. 40 cases patients of the experimental group received minimally invasive surgery and on the basis of conventional anti-inflammatory drug, GnRH-a add-back treatment was used. Then the clinical efficacy and relapse rate of the two groups were compared. Results The efficiency of the experimental group（ 85% ）was higer than the control group（45% ）, and the difference of the two group was statistically significant （P 〈 0.05 ）. The recurrence rate of the experimental group （7.5 % ） was lower than the control group（32.5% ）, and the difference of the two group was statistically significant（P 〈0.05）. The pregnancy of the experimental group（40.9% ）was higher than the control group（34.8% ）, and the difference of the two group was not statistically significant （ P 〉 0.05 ）. The adverse drug reactions of the experimental group was 10%, and the difference of the two group was not statistically significant （P 〉 0.05）. Conclusion Minimally invasive surgery combined GnRH-a in the treatment of endometriosis is safe and efficient.