保守手术联合不同药物对子宫内膜异位症改善妊娠的临床分析.docVIP

保守手术联合不同药物对子宫内膜异位症改善妊娠的临床分析 　　摘要：目的 保守手术联合各类药物在子宫内膜异位症治疗中改善妊娠的临床效果。方法 收集我院子宫内膜异位症保守术术后联合药物治疗方面的随机对照试验，以孕三烯酮为代表药物对照其他常用治疗子宫内膜异位症的药物在改善妊娠方面的数据进行分析。结果 子宫内膜异位症保守手术术后应用孕三烯酮与单纯保守手术组比较在改善妊娠情况优于单纯手术组（P0.00001），保守手术术后应用孕三烯酮与保守手术术后应用GnRH-a比较在改善妊娠情况不如GnRH-a（P0.00001），保守术后应用孕三烯酮、妈富隆、米非司酮、达那唑在改善妊娠方面疗效相当。结论 子宫内膜异位症保守手术术后应用药物治疗较单纯手术可明显提高妊娠率；保守术后应用GnRH-a在改善妊娠方面优于孕三烯酮；保守术后应用孕三烯酮、妈富隆、米非司酮、达那唑在改善妊娠方面疗效相当。 　　关键词：子宫内膜异位症；药物治疗；孕三烯酮；GnRH-a；米非司酮；达那唑；妈富隆 　　Abstract：Objective Clinical application value of the conservative surgery with various types of drugs in the treatment of endometriosis.Methods To collect relevant randomized controlled trials of the conservative surgery with drugs in the treatment of endometriosis.To take gestrinone as the representative drug compared with other commonly used drugs in the treatment of endometriosis，and the data in the aspect of improve the pregnancy.Results Compared endometriosis after conservative surgery using gestrinone group with conservative surgery alone group，improve the pregnancy is better than surgery alone group（P0.00001），Compared endometriosis after conservative surgery using gestrinone group with endometriosis after conservative surgery using GnRH-a group improve the pregnancy is not as good as GnRH-a（P0.00001），There is similar efficacy in improve the pregnancy rate after conservative surgery using gestrinone，Marvelon，mifepristone，and danazol.Conclusion Endometriosis after conservative surgery using drug therapy can significantly improve the pregnancy.Endometriosis after conservative surgery using GnRH-a is superior to gestrinone in improve the pregnancy.There is similar efficacy in improve the pregnancy rate after conservative surgery using gestrinone，Marvelon，mifepristone，and danazol. 　　Key words：Endometriosis；drug therapy；Gestrinone；GnRH-a；Mifepristone；Danazol；Marvelon 　　子宫内膜异位症是指出现在正常宫腔以外的拥有子宫内膜活性的组织引起的具有侵袭性、复发性的激素依赖性疾病，属于慢性疾病，人群中的发病率约在10%～15%[1]，是最常见的妇科疾病之一，本病除引起疼痛外，还能引起不孕，患者宫内膜异位症的患者不孕率高达50%。由于子宫内膜异位症疾病本身的特点，对于中重度的子宫内膜移位症，以及单纯药