腹腔镜手术联合促性腺激素释放激素激动剂治疗子宫内膜异位症的临床研究

目的 探讨腹腔镜手术联合促性腺激素释放激素激动剂治疗子宫内膜异位症的临床效果.方法 选取广东省中山市中医院2010年1月至2011年12月子宫内膜异位症患者80例,将其按照随机数字法分为对照组（40例）和研究组（40例）.对照组患者行单纯腹腔镜手术治疗,研究组行腹腔镜手术后给予促性腺激素释放激素激动剂,术后第1次的月经来潮第1～3天在其腹部前壁皮下注射3.6 mg醋酸戈舍瑞林,间隔28d进行1次,共治疗3次.术后随访观察2年,观察2组的临床疗效、复发率及妊娠率.结果 研究组总有效率为77.5％ （31/40）,对照组总有效率为47.5％ （19/40）,研究组总有效率明显高于对照组,差异有统计学意义（P＜0.05）.对照组妊娠率为44.0％（11/25）,研究组妊娠率为60.0％（18/30）,2组比较差异有统计学意义（P＜0.05）.研究组复发率为10.0％ （4/40）,对照组复发率为22.5％（9/40）,2组比较差异有统计学意义（P＜0.05）.结论 子宫内膜异位症患者行腹腔镜手术治疗之后给予促性腺激素释放激素激动剂治疗能有效提高临床疗效和妊娠率,降低复发率.

Clinical research on laparoscopic surgery combined with gonadotropin-releasing hormone agonist in the treatment of endometriosis

Objective To investigate the clinical effects of laparoscopic surgery combined with gonadotropin-releasing hormone agonist in the treatment of endometriosis.Methods Totally 80 patients with endometriosis from January 2010 to December 2011 were selected and randomly divided into control group （40 cases） and study group （40 cases）.Patients of the control group were given simple laparoscopic surgery and study group was given gonadotropin-releasing hormone after laparoscopic surgery.Patients of the research group were given 3.6 mg goserelin acetate in abdominal anterior wall with subcutaneous injection after the first menstrual period of 1-3 days,one time interval of 28 days,total treatment of 3 times.Follow-up was 2 years after operation.Clinical curative effect,recurrence rate and pregnancy rate of two groups were observed.Results The clinical total effective rate of study group was 77.5% （31/41）.It was 47.5% （19/40）in the control group;the study group＆#39;s clinical total effective rate was significantly higher than that of the control group （P 〈 0.05）.Pregnancy rate of control group was 44.0% （11/25） and it was 60.0% （18/30） in the study group ; there was a significant difference between the two groups （P 〈0.05）.The recurrence rate of the study group was 10.0% （4/40）and the recurrence rate of the control group was 22.5 % （9/40） ; there was a significant difference between the two groups （P 〈 0.05）.Conclusion Laparoscopic surgery combined with gonadotropin-releasing hormone agonist in the treatment of endometriosis can effectively improve the efficacy and clinical pregnancy rate,as well as reduce the relapse rate.