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目的探讨腹腔镜联合药物治疗中重度子宫内膜异位症的疗效。方法回顾性分析2003年2月至2008年2月确诊为Ⅲ～Ⅳ期子宫内膜异位症患者358例的临床资料,分为A、B、C、D4组。A组(67例)为术后未用药物巩固治疗组,B组(93例)为术后加用米非司酮组,C组(101例)为术后加用孕三烯酮组,D组(97例)为术后加用诺雷德组。疗程均为6个月。比较4组患者术后复发率、妊娠结局及药物副作用等。结果与A组相比,B、C、D3组的症状缓解率、术后2年妊娠率明显提高,复发率明显下降(P均<0.05);而在B、C、D3组的疗效比较中,C、D2组间的症状缓解率、复发率及术后2年妊娠率无明显差异(P>0.05),但均优于B组,差异有统计学意义(P均<0.05)。C组以痤疮最常见,D组以低雌激素副反应为主,均于停药后恢复。结论在腹腔镜术后加用抑制卵巢功能药物对提高妊娠率、降低复发率有重要意义。
Objective To investigate the efficacy of laparoscopic combined with medicine in the treatment of moderate-severe endometriosis. Methods The clinical data of 358 patients with stage Ⅲ ~ Ⅳ endometriosis diagnosed from February 2003 to February 2008 were retrospectively analyzed and divided into groups A, B, C and D4. Group A (67 cases) were treated with no medication to consolidate the treatment group, group B (93 cases) were treated with mifepristone group, group C (101 cases) were treated with gestrinone group, Group D (n = 97) was noread group. Course of treatment are 6 months. The recurrence rate, pregnancy outcome and drug side effects were compared between the 4 groups. Results Compared with group A, the symptom relief rates of group B, C and D3 were significantly improved (P <0.05), but the recurrence rates of group B and C were significantly lower than those of group A There was no significant difference in symptom relief rate, recurrence rate and 2-year pregnancy rate between C and D2 groups (P> 0.05), but both were better than B group (P <0.05). Group C was the most common acne, Group D was mainly low-estrogen side effects, were recovered after withdrawal. Conclusions After laparoscopic surgery combined with inhibition of ovarian function drugs to improve pregnancy rate and reduce the recurrence rate of great significance.