腹腔镜联合药物治疗中重度子宫内膜异位症的临床观察  

Clinical Observation of Laparoscopic Operation Combined with Drug Therapy on Advanced Endometriosis

作　　者：黄芳[1] 李玲[1] 李琼珍[1] 陈婉[1] 

机构地区：[1]广东省肇庆市第一人民医院妇科,526021

出　　处：《中国医药指南》2009年第9期23-25,共3页Guide of China Medicine

摘　　要：目的探讨腹腔镜联合药物治疗中重度子宫内膜异位症的临床价值。方法选择经腹腔镜手术诊断并治疗的中重度子宫内膜异位症患者62例,术后随机分为3组,孕三烯酮组(22例):术后第3天开始服孕三烯酮2.5mg,每周2次;达那唑组(20例):术后第3天开始服达那唑0.2g,2次/d,两药均连用3～6个月;未用药组(20例)。所有患者随访12个月,观察疗效。结果孕三烯酮组、达那唑组、未用药组有效率分别为86.36%、85.0%、55.0%;复发率分别为9.09%、15.0%、45.0%;妊娠率分别为36.36%、35.0%、5%。两用药组与未用药组比较差异均有显著意义(P<0.05),但用药组之间比较差异无显著意义(P>0.05)。孕三烯酮组、达那唑组肝损率分别为13.63%、50.0%;体质理增加率分别为9.09%、40.0%,差异有显著意义(P<0.05)。结论腹腔镜联合药物治疗中重度内异症疗效确切,能降低复发率,提高妊娠率。且孕三烯酮较达那唑不良反应小,使用方便。Objective To explore clinical value of Laparoscopic Operation combined with drug therapy on Advanced Endometriosis. Methods 62 cases of advanced endometriosis patients were randomly divided into 3 groups after diagnosed and treated by laparoscopic operation.Gestrinone group （n=22）： the patients were given 2.5rag of gesainone at the 3th day, twice a week; danazol group（n=20）： the patients were given 0.2g danazol at the 3th day, twice a day ,both drugs were given for 3-6 months;control group（n=20）： were given no drugs. All patients were observed for 12 months. Results The effective rate of gestrinone group, danazol group and control group were 86.36%, 85.0% and 55.0% respectively; the recurrent rate were 9.09%, 15.0%, 45.0% respectively; the pregnancy rate were 36.36%, 35.0%, 5% respectively. There was significant difference between the two drug group and control group （P〈0.05）, but there was no significant difference between the two drug group（P〉0.05）. The incidence of liver damage in gestrinone group and danazol group were 13.63%, 50.0% respectively; The rate of gain weight were 9.09%, 40.0% respectively. There was a significant difference in two groups （P〈0.05）. Conclusion Laparoscopic operation combined with drug therapy is a safe and effective therapeutic means for advanced endometriosis, and can significantly decrease the recurrence rate and increase the pregnancy rate. Compared with danazol, gestrinone has little adverse reaction and easy performation.

关 键 词：中重度子宫内膜异位症 腹腔镜 孕三烯酮 达那唑 

分 类 号：R711.71[医药卫生—妇产科学]