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目的比较子宫内膜异位症(EMs)腹腔镜手术治疗辅以曲普瑞林或孕三烯酮药物治疗的疗效观察。方法 76例EMs患者均先行腹腔镜手术治疗,术后随机分为曲普瑞林组(A组)和孕三烯酮组(B组),每组各38例。所有患者均于术后1周开始药物治疗,治疗周期均为6个月。A组:曲普瑞林3.75 mg/次,肌肉注射,每28 d 1次,连续6次;B组:孕三烯酮2.5 mg/次,口服,2次/周。结果所有患者痛经症状均得到不同程度缓解,A组(97.4%)有效率优于B组(89.5%),P<0.05;A组(2.6%)停药1年复发率低于B组(10.5%),P<0.05。术后1年妊娠率A组(26.3%)和B组(21.1%)相似。A组与B组不良反应发生率分别为10.5%与60.5%,发生不良反应率差异有统计学意义(P<0.05)。结论腹腔镜手术是治疗EMs的主要治疗手段,术后应用曲普瑞林、孕三烯酮等药物巩固治疗可明显改善症状、降低复发率。曲普瑞林相对于孕三烯酮具有疗效显著,不良反应轻的优势。
Objective To compare the efficacy of laparoscopic surgery of endometriosis (EMs) with triptorelin or gestrinone treatment. Methods A total of 76 patients with EMs were treated with laparoscopic surgery. The patients were randomly divided into triptorelin group (A group) and gestrinone group (B group), 38 cases in each group. All patients started the drug treatment 1 week after the operation, the treatment cycle was 6 months. Group A: triptorelin 3.75 mg / time, intramuscular injection every 28 d for 6 consecutive times; Group B: gestrinone 2.5 mg / time, orally, 2 times / week. Results The symptoms of dysmenorrhea in all patients were relieved to some extent. The effective rate of group A (97.4%) was better than that of group B (89.5%), P <0.05. The recurrence rate of group A (2.6% %), P <0.05. The 1-year pregnancy rate was similar in group A (26.3%) and group B (21.1%). The incidence of adverse reactions in group A and group B was 10.5% and 60.5%, respectively, and the difference in adverse reaction rate was statistically significant (P <0.05). Conclusion Laparoscopic surgery is the main treatment for the treatment of EMs. Postoperative application of triptorelin and gestrinone can significantly improve the symptoms and reduce the recurrence rate. Triptorelin relative Gestrinone has a significant effect, the advantages of light adverse reactions.