腹腔镜联合药物治疗重度子宫内膜异位症疗效观察

目的探讨重度子宫内膜异位症患者腹腔镜保守术后不同药物巩固治疗的效果。方法选择2009年10月～2010年6月我院行腹腔镜治疗的重度子宫内膜异位症患者99例,术后随机分为两组,促性腺激素释放激素（GnRH-a）组50例,术后每4周皮下注射GnRH-a 3.75 mg,共3～6个月;孕三烯酮组49例,术后口服孕三烯酮胶囊2.5 mg,每周2次,共用3～6个月。两组中共有33例合并不孕症,其中GnRH-a组18例,孕三烯酮组15例。比较两组的术后总有效率、妊娠率和不良反应情况。结果 GnRH-a组的术后总有效率和妊娠率均明显高于孕三烯酮组,差异均有统计学意义（均P〈0.05）;GnRH-a组患者不良反应情况好于孕三烯酮组,差异有统计学意义（P〈0.05）。结论重度子宫内膜异位症患者腹腔镜保守术后联合应用GnRH-a在提高术后缓解率和妊娠率方面优于孕三烯酮。

Clinical observation on laparoscopy combined with drugs in the treatment of severe endometriosis

Objective To investigate the effect of severe endometriosis patients undergoing laparoscopic conservative opera tion after different drug therapy to consolidate.Methods 99 patients with severe endometriosis in our hospital from October 2009 to June 2010 were randomly divided into two groups.50 cases were sent to GnRH-a group,3.75 mg GnRH-a were subcutaneously injected postoperatively every 4 weeks in a total of 3-6 months;49 cases were sent to gestrinone group,2.5 mg Gestrinone were taken orally postoperatively every 2 weeks in a total of 3-6 months.A total of 33 patients with in fertility were in the two groups with 18 cases in GnRH-a group and 15 cases in gestrinone group.Postoperative total effi ciency,pregnancy rate and adverse reactions were compared.Results Total effective rate and pregnancy rate were significantly higher in GnRH-a group than those in gestrinone group,the differences were all statistically significant（all P0.05）;the rate of adverse reactions were lower than those in gestrinone group,the differences were statistically significant（P0.05）.Conclusion Severe endometriosis patients with laparoscopic conservative operation combined application of GnRH-a can improve postoperative remission rate and pregnancy rate,the efficacy is better than Gestrinane.