子宫内膜异位症伴不孕患者行腹腔镜联合药物治疗效果观察

目的观察子宫内膜异位症伴不孕患者行腹腔镜联合药物治疗的临床疗效。方法选择2009年6月至2011年6月厦门长庚医院收治的Ⅲ^Ⅳ期盆腔子宫内膜异位症伴不孕患者84例,按照不同的治疗方法分为观察组和对照组,各42例,两组患者均采用腹腔镜手术治疗,观察组患者在腹腔镜治疗的基础上加用药物(醋酸戈舍瑞林缓释植入剂)治疗。比较两组患者治疗后的妊娠率、CA125水平。结果治疗后观察组患者的治疗术后妊娠率为47.62%,对照组为16.67%,两组比较观察组的妊娠率显著高于对照组(P<0.05);两组患者治疗后的CA125水平均发生显著改善,且观察组改善情况优于对照组(P<0.01);治疗后观察组患者的不良反应发生率低于对照组(2.38%vs19.05%),两组比较差异有统计学意义(P<0.05)。结论采用腹腔镜手术合并药物治疗ⅢⅣ期盆腔子宫内膜异位症伴不孕患者84例,按照不同的治疗方法分为观察组和对照组,各42例,两组患者均采用腹腔镜手术治疗,观察组患者在腹腔镜治疗的基础上加用药物(醋酸戈舍瑞林缓释植入剂)治疗。比较两组患者治疗后的妊娠率、CA125水平。结果治疗后观察组患者的治疗术后妊娠率为47.62%,对照组为16.67%,两组比较观察组的妊娠率显著高于对照组(P<0.05);两组患者治疗后的CA125水平均发生显著改善,且观察组改善情况优于对照组(P<0.01);治疗后观察组患者的不良反应发生率低于对照组(2.38%vs19.05%),两组比较差异有统计学意义(P<0.05)。结论采用腹腔镜手术合并药物治疗Ⅲ^Ⅳ期盆腔子宫内膜异位症能够有效提高妊娠率,降低CA125水平,是治疗子宫内膜异位症伴不孕的有效方法,水平得临床广泛推广。

Laparoscopic Treatment Combined with Medication for Patients with Endometriosis Associated with Infertility

Objective To analyze the treatment methods and effects of laparoscopy combined with medi- cation for patients with endometriosis associated with infertility. Methods A total of 84 patients with endo- metriosis at Ⅲ-Ⅳ stage associated with infertility admitted in Xiamen Chang Gung Hospital from Jun. 2009 to Jun. 2011 were randomly divided into the control group and the observation group with 42 patients in each group. Patients in both group were treated with laparoscopic surgery,while medication（ goserelin acetate sus- tained-release implant） treatment was added to the patients in the observation group. The pregnancy rates, CA125 levels,and adverse reactions after treatment were compared. Resulls After treatment,the postopera- tive pregnancy rates of the observation group and the control group were 47.62% and 16.67% respectively, and the difference between the two groups was statistically significant （P 〈 0.05 ）. The CA125 levels of the patients in both groups were significantly improved, while the improvement of CA125 levels of the observation group was more significant than that of the control group, with a statistically significant difference （ P 〈 0.01 ）. The incidence of adverse reactions of the observation group were significantly lower than that of the control group（2.38% vs 19.05% ） ,with a statistical significant difference（P 〈0.05）. Conclusion Lapa- roscopic surgery combined with medication can increase the pregnancy rate, lower the CA125 level and reduce the incidence of adverse reactions. It is an effective treatment method of endometrlosls associated with infertility and is worth being widely spread in clinical practice.