腹腔镜手术联合促性腺激素释放激素激动剂治疗内异症疗效研究.docVIP

腹腔镜手术联合促性腺激素释放激素激动剂治疗内异症疗效研究 　　【摘要】 目的 探?比较腹腔镜手术与促性腺激素释放激素激动剂（GnRH-a）不同方式的联合应用对盆腔子宫内膜异位症（内异症）的疗效。方法 137例中、重度内异症患者， 随机分为甲组（53例）、乙组（47例）和丙组（37例）。甲组患者术前术后各使用醋酸亮丙瑞林3个月；乙组患者直接行腹腔镜手术， 根据术中情况术后使用醋酸亮丙瑞林3～6个月；丙组患者单纯行腹腔镜手术。比较三组术中情况及疗效。结果 甲组手术时间、术后肛门排气时间均短于乙组和丙组， 术中出血量少于乙组和丙组， 差异具有统计学意义（P0.05）。术后随访1年， 三组患者失访7例， 随访率为94.89%。甲组和乙组治疗总有效率分别为96.23%、95.74%， 均高于丙组的81.08%， 差异具有统计学意义（P0.05）。丙组无不良反应发生， 甲组与乙组不良反应发生率均高于丙组， 差异具有统计学意义（P0.05）， 多为用药期间潮热、盗汗和少量不规则阴道流血。甲组复发率均低于乙组和丙组， 差异具有统计学意义（P0.05）。结论 术前使用GnRH-a有利于手术的实施， 腹腔镜手术联合使用GnRH-a能有效抑制内异症复发。 　　【关键词】 盆腔子宫内膜异位症；促性腺激素释放激素激动剂；腹腔镜手术 　　DOI：10.14163/j.cnki.11-5547/r.2017.07.068 　　Research of curative effect by laparoscopic surgery combined with gonadotropin releasing hormone agonist in the treatment of pelvic endometriosis LYU Sha， XU Xiao-xiao. Department of Obstetrics and Gynecology， Affiliated Hospital of Guizhou Medical University， Guiyang 550004， China 　　【Abstract】 Objective To investigate curative effect by laparoscopic surgery combined with gonadotropin releasing hormone agonist （GnRH-a） in the treatment of pelvic endometriosis. Methods A total of 137 patients with moderate and severe pelvic endometriosis were randomly divided into group A （53 cases）， group B （47 cases） and group C （37 cases）. Group A received preoperative and postoperative leuprolide acetate respectively for 3 months. Group B received laparoscopic surgery， followed by postoperative leuprolide acetate for 3～6 months. Group C received single laparoscopic surgery. Intraoperative condition and curative effect were compared in the three groups. Results Group A had shorter operation time， postoperative anal exhaust time， and less intraoperative bleeding volume than groups B and C. Their difference had statistical significance （P0.05）. Postoperative 1-year follow-up showed 7 losing cases in the three groups， with follow-up rate as 94.89%. Group A and group B had total effective rate in treatment respectively as 96.23% and 95.74%， which were both higher than 81.08% in grou