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目的探讨性腺激素释放激素激动剂(GnRH-a)辅助腹腔镜治疗子宫内膜异位症(EMs)的临床效果,并观察和分析其预后,为临床治疗提供依据。方法选择2011年7月~2013年4月在本院治疗的EMs患者114例,随机分为对照组和观察组,两组各57例,对照组应用腹腔镜术及口服孕三烯酮进行治疗;观察组应用戈舍瑞林辅助腹腔镜治疗。主要评估临床治疗效果、不良反应,临检测血清促卵泡激素(FSH)、促黄体生成素(LH)、雌二醇(E2)含量;并对评估患者1年复发率。结果观察组基本治愈率为63.16%,高于对照组54.39%,两组比较,差异有统计学意义(P<0.05);两组1年复发率结果比较,差异无统计学意义(P>0.05);观察组患者术后3个月和6个月FSH和LH水平分别为(40.89±2.14)U/L、(42.18±1.66)U/L和(39.96±2.40)U/L、(44.58±2.07)U/L,均高于对照组(P<0.05);观察组术后3个月和6个月E2水平为(44.83±2.16)pmol/L和(40.15±2.03)pmol/L,低于对照组(P<0.05);观察组总不良发生率为14.04%,低于对照组,两组比较,差异有统计学意义(P<0.05)。结论 GnRH-a辅助腹腔镜治疗EMs具有较好的临床疗效,改善患者雌激素水平,减轻患者不良反应发生率,值得临床推广应用。
Objective To investigate the clinical efficacy of GnRH-a assisted laparoscopy in the treatment of endometriosis (EMs) and to observe and analyze the prognosis of the patients with endometriosis. Methods 114 patients with EMs treated in our hospital from July 2011 to April 2013 were randomly divided into control group and observation group, 57 cases in each group. The control group was treated by laparoscopy and oral gypentenone The observation group was treated with goserelin assisted laparoscopy. The main clinical evaluation of the treatment effect, adverse reactions, clinical detection of serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) content; and to evaluate the patient 1 year recurrence rate. Results The cure rate of the observation group was 63.16%, which was higher than that of the control group (54.39%). There was significant difference between the two groups (P <0.05). There was no significant difference in the 1-year recurrence rate between the two groups (P> 0.05 ). The levels of FSH and LH in observation group were (40.89 ± 2.14) U / L, (42.18 ± 1.66) U / L and (39.96 ± 2.40) U / L respectively at 3 and 6 months after operation 2.07) U / L were higher than those in the control group (P <0.05). The levels of E2 in the observation group were (44.83 ± 2.16) pmol / L and (40.15 ± 2.03) pmol / L at 3 and 6 months after operation In the control group (P <0.05). The total incidence of adverse events in the observation group was 14.04%, which was lower than that in the control group. There was significant difference between the two groups (P <0.05). Conclusion GnRH-a assisted laparoscopic treatment of EMs has better clinical efficacy, improve estrogen levels, reduce the incidence of adverse reactions in patients, it is worth promoting the clinical application.