手术联合药物治疗中重度子宫内膜异位症的疗效观察

目的探讨手术联合药物治疗中重度子宫内膜异位症的临床疗效。方法选择2005年1月至2009年10月我院收治确诊为Ⅲ～Ⅳ期子宫内膜异位症的患者共90例,将其随机平均分为两组,1组45例,为术后加用孕三烯酮,2组45例,为术后加用诺雷德治疗。两组疗程均为6个月。所有患者均随访2年,比较两组患者术后疗效、复发率、妊娠率及药物副作用。结果诺雷德组术后疗效、复发率、妊娠率均优于孕三烯酮组,差异均有统计学意义（P〈0.05）。孕三烯酮组药物副反应以肝功能影响及高雄激素症状为主,停药1～6个月恢复;诺雷德组表现为低雌激素所致的更年期症状,于停药后1～2个月恢复,低雌激素以反向添加疗法预防。结论手术后联合诺雷德治疗中重度子宫内膜异位症的疗效比联合孕三烯酮好,值得临床推广应用。

Curative effect of surgery joint drug in treatment of endometriosis

Objective To study the curative effect of surgery joint drug in the treatment of endometriosis.Methods 90 patients from January 2005 to October 2009 who were diagnosed asⅢ～Ⅳperiod endometriosis were slected,and were randomly divided into two groups 45 cases in each,one group of 45 patients added gestrinone after surgery,two group of 45 patients added zoladex after surgery.The course of two groups were six months.All patients were followed up for 2 years.The response rate,recurrence rate,pregnancy rate and drug side effects were compared of two groups.Results The remission rates,recurrence rate,pregnancy rate of zoladex group was better than gestrinone group,the differences were statistically significant（P〈0.05）,drug side effects of gestrinone group with liver function effect and high androgen symptoms was given priority to stop taking 1～6 months restore,zoladex group showed low estrogen for is the result of menopausal symptoms,stop drug in 1 to 2 months after recovery,low estrogen to reverse add therapy prevention.Conclusion The curative effect of surgery joint zoladex in treatment of endometriosis is better than gestrinone,and is worthy of clinical application.