子宫内膜异位症腹腔镜术后应用促性腺激素释放激素激动药联合去氧孕烯炔雌醇的疗效  

Clinical effect of Gnrh-A assisted laparoscopic surgery for endometriosis and its effects on endocrine hormone and pregnancy

作　　者：王丽华[1] 徐景杰[1] 张嫱 WANG Lihua;XU Jingjie;ZHANG Qiang(The Inner Mongolia Autonomous Region Corps Hospital of Chinese People's Anned Police Force, Hohhot 010040, China)

机构地区：[1]武警内蒙古总队医院妇产科,呼和浩特010010

出　　处：《武警医学》2019年第3期189-192,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨子宫内膜异位症腹腔镜术后应用促性腺激素释放激素激动药(gonadotropin-releasing hormone agonist,GnRH-a)联合去氧孕烯炔雌醇的效果。方法选择医院收治的64例子宫内膜异位症患者,随机分成研究组(32例)和对照组(32例),均行腹腔镜手术,对照组给予去氧孕烯炔雌醇治疗,研究组给予去氧孕烯炔雌醇与GnRH-a联合治疗,比较两组治疗后内分泌激素水平、月经周期及妊娠率等。结果治疗后研究组LH[(2. 05±0. 43) mmol/L]、FSH[(4. 36±0. 52) mmol/L]、E2[(15. 37±2. 46) pg/ml]均优于对照组(P <0. 05);研究组盆腔痛评分[(0. 38±0. 11)分]、痛经评分[(2. 38±0. 62)分]均低于对照组(P <0. 05);研究组月经周期恢复时间[(86. 21±8. 04) d]、月经量恢复正常时间[(54. 56±5. 42) d]均短于对照组(P <0. 05);研究组妊娠率(59. 38%)高于对照组(31. 25%)(P <0. 05)。结论子宫内膜异位症实施腹腔镜手术后给予去氧孕烯炔雌醇联合GnRH-a治疗的效果显著,可显著减少内分泌激素水平,改善临床症状,降低复发率。Objective To analyze the therapeutic effect of GnRH-a combined with desogestrel and ethinylestradiol against endometriosis and the effect on endocrine hormone and pregnancy. Methods Sixty-four patients with endometriosis diagnosed in our hospital between August 2016 and February 2018 were randomly divided into the study group( n = 32) and the control group( n = 32).All the patients underwent laparoscopic surgery. The control group was treated with desogestrel and ethinylestradiol,while the study group received GnRH-a combined with desogestrel and ethinylestradiol. The therapeutic effects were compared between the two groups.Results The levels of LH,FSH and E2 in the study group were( 2. 05 ± 0. 43) mmol/L,( 4. 36 ± 0. 52) mmol/L and( 15. 37 ±2. 46) pg/m L respectively,all of which were better than those of the control group( P < 0. 05). The scores of pelvic pain,dysmenorrhea and dyspareunia were( 0. 38 ± 0. 11),( 2. 38 ± 0. 62) and( 0. 08 ± 0. 02) points in the study group,lower than in the control group( P < 0. 05). The recovery time of the menstrual cycle and the time taken by the menstrual blood volume to return to normal was( 86. 21 ± 8. 04) d and( 54. 56 ± 5. 42) d in the study group,both of which were shorter than in the control group( P < 0. 05). The pregnancy rate( 59. 38%),recurrence rate,and incidence of adverse reactions( 12. 50%) in the study group compared favorably with the control group( P < 0. 05). Conclusions For recipients of laparoscopic surgery for endometriosis,GnRH-a combined with desogestrel and ethinylestradiol is quite effective,which can help reduce the level of endocrine hormone,improve clinical symptoms and pregnancy rate,induce fewer adverse reactions or cases of recurrence.

关 键 词：去氧孕烯炔雌醇 促性腺激素释放激素激动药 子宫内膜异位症 腹腔镜 内分泌激素 妊娠 

分 类 号：R711[医药卫生—妇产科学]