腹腔镜联合药物治疗卵巢子宫内膜异位囊肿合并不孕的疗效分析

目的探讨腹腔镜联合药物治疗中重度卵巢子宫内膜异位囊肿(OEM)合并不孕的临床疗效。方法选取我院在2011年1月至2014年1月收治的中重度OEM合并不孕患者120例,随机分为A组、B组和对照组各40例,三组患者均行腹腔镜保守性手术治疗,对照组术后不联合药物治疗,A、B两组术后联合药物治疗,其中A组给予诺雷德肌肉注射,B组给予孕三烯酮胶囊口服治疗,并比较三组术后性激素水平、妊娠率、复发率和安全性。结果性激素水平的比较,A组、B组术后6个月FSH、LH、E2、CA125等指标均明显优于对照组(p<0.05);妊娠率和复发率比较,A组、B组两组妊娠率明显大于对照组(p<0.05),复发率明显小于对照组(p<0.05),且A组复发率明显小于B组(p<0.05);A组4例(10%)患者出现谷丙转氨酶(ALT)、谷草转氨酶(AST)转高,其它两组无不良事件发生。结论腹腔镜联合药物治疗中重度OEM合并不孕效果显著,可明显降低复发率提高妊娠率,且给予诺雷德治疗可更好的降低复发率,且安全性高。

CURATIVE EFFECTS OF LAPAROSCOPE COMBINED WITH DRUG THERAPY ON OVARIAN ENDOMETRIOSIS CYST COMBINED WITH INFERTILITY

Objective To study the curative effect of laparoscope combined with medication on ovarian endometriosis cyst（ OEM） combined with infertility. Methods 120 patients with moderate to severe OEM combined with infertility admitted in our hospital from January 2011 to January 2014 were selected and divided into group A,group B and the control group. The patients in all the three groups underwent laparoscopic conservative surgery. Besides,the control group was not combined with drug therapy,and groups A and B received postoperative therapy,with group A given intramuscular injection of Zoladex,and group B oral administration with Gestrinone capsule. The postoperative sex hormone levels,pregnancy rate,recurrence rate and safety of the three groups were then compared among the groups. Results In terms of the sex hormone levels,FSH,LH,E2,CA125 and other indicators of groups A and B six months after surgery were significantly better than the control group（ p〈0. 05）; The pregnancy rate and recurrence rate in groups A and B were significantly higher than the control group（ p〈0. 05） and the recurrence rate was significantly lower than the control group（ p〈0. 05） ： the recurrence rate of group A was significantly lower than that in group B（ p〈0. 05）. 4 patients in group A（ 10%） suffered from increasing alanine aminotransferase（ ALT）,aspartate aminotransferase（ AST）. There was no other adverse reactions. Conclusion Laparoscope combined with medication is significant in severe OEM with infertility in that it may significantly reduce the recurrence rate and increase pregnancy rate. Besides,therapy with Zoladex can better reduce the recurrence rate and increase the safety.