腹腔镜手术联合戈舍瑞林缓释植入剂治疗子宫内膜异位症合并不孕症3年随访观察  

Observation of the effect in 3 years of followed up after goserelin sustained-release implants combined with laparoscopic surgery for treating infertility women with endometriosis

作　　者：庞海霞 孙静莉 PANG Haixia;SUN Jingli(General Hospital of the northern theater of the Chinese people's Liberation Army,Shenyang,Liaoning Province,110003)

机构地区：[1]中国人民解放军北部战区总医院,沈阳110003

出　　处：《中国计划生育学杂志》2021年第3期452-456,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨腹腔镜手术联合醋酸戈舍瑞林缓释植入剂治疗子宫内膜异位症(EMS)合并不孕症患者3年随访效果。方法:选取2014年2月—2017年2月本院收治的EMS合并不孕症200例为研究对象,采用随机数字法分为对照组和观察组各100例。两组均行腹腔镜手术治疗,观察组给予醋酸戈舍瑞林缓释植入剂治疗,比较两组临床疗效、疼痛改善情况、性激素水平[卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)]、血清炎性因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、可溶细胞间黏附因子-1(sICAM-1)]、不良反应发生率、3年内复发率和妊娠结局。结果:观察组治疗有效率(95.0%)高于对照组(78.0%)(P<0.05);治疗后观察组痛经、性交痛及盆腔触痛评分和血清FSH、LH、E2、CRP、TNF-α、IL-6、sICAM-1水平均低于对照组(P<0.05);两组不良反应发生率比较无差异(P>0.05);观察组3年复发率(7.0%)低于对照组(22.0%),妊娠率(75.0%)高于对照组(50.0%)(P<0.05)。结论:腹腔镜手术联合醋酸戈舍瑞林缓释植入剂治疗EMS合并不孕症疗效显著,可维持患者雌激素水平,降低炎性因子,改善妊娠结局,降低复发率,且安全性较高。Objective:To investigate the effect in 3 years of followed up after goserelin sustained-release implants combined with laparoscopic surgery for treating infertility women with endometriosis(EMS).Methods:200 infertility women with EMS were selected and were divided into two groups(100 cases in each group)by random number method between February 2014 and February 2017.The women in the control group were treated with laparoscopic surgery,and the women in the observation group were treated with goserelin acetate sustained-release implants combined with laparoscopic surgery.The clinical effect,the situation of pain relief,the levels of sex hormones,such as follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),and the levels of serum inflammatory factors,such as C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),soluble intercellular adhesion factor-1(SICAM-1),the incidences of adverse reactions and recurrence within 3 years,and pregnancy outcomes of the women were compared between the two groups.Results:The effective rate(95.0%)of the women in the observation group was significant higher than that(78.0%)of control group(P<0.05).After treatment,the scores of dysmenorrhea,dysmenorrhea,and pelvic tenderness,and serum levels of FSH,LH,E2,CRP,TNF-α,IL-6 and sICAM-1 of the women in the observation group were significant lower than those of the women in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions of the women between the two groups(P>0.05).The recurrence rate within 3 years(7.0%)of the women in the observation group was significant lower than that(22.0%)of the women in the control group,but the pregnancy rate(75.0%)of the women in the observation group was significant higher than that(50.0%)of the women in the control group(P<0.05).Conclusion:Goserelin acetate sustained-release implants combined with laparoscopic surgery for treating infertility women with EMS is effectiveness,which can maintain the estrogen levels,reduce inf

关 键 词：子宫内膜异位症 不孕症 腹腔镜手术 醋酸戈舍瑞林缓释植入剂 妊娠结局 复发 3年随访 

分 类 号：R711.71[医药卫生—妇产科学] R711.6[医药卫生—临床医学]