腹腔镜术后醋酸戈舍瑞林缓释植入剂治疗卵巢型子宫内膜异位症临床疗效及术后复发相关因素分析  

Clinical efficacy of goserelin acetate sustained-release implant inserted after laparoscopic surgery for treating patients with ovarian endometriosis and analysis of related factors of postoperative recurrence of endometriosis

作　　者：孙利娟 李涛[1] 张琼[1] SUN Lijuan;LI Tao;ZHANG Qiong(The Third People's Hospital of Chengdu,Chengdu,Sichuan Province,610014)

机构地区：[1]四川省成都市第三人民医院,610014

出　　处：《中国计划生育学杂志》2022年第11期2537-2542,共6页Chinese Journal of Family Planning

摘　　要：目的:探讨卵巢型子宫内膜异位症腹腔镜术后分别联合孕三烯酮或醋酸戈舍瑞林植入剂治疗临床疗效,分析复发影响因素。方法:将2016年1月-2020年10月于本院完成腹腔镜手术治疗的卵巢型子宫内膜异位症170例,按随机数字表法分为对照组与观察组各85例,术后分别接受孕三烯酮或醋酸戈舍瑞林植入剂治疗,连续4~6个周期,比较两组治疗效果及血清生殖激素水平、主要症状及改善情况,统计不良反应、随访1年的复发率,logistic多因素分析异位症复发的相关影响因素。结果;观察组总疗效(90.6%)高于对照组(77.7%),治疗6个月后生殖激素降低幅度高于对照组,痛经、性交痛、盆腔疼痛评分低于对照组(均P<0.05),不良反应发生率(18.8%)与对照组(16.5%)无差异(P>0.05),术后1年复发率(8.2%)低于对照组(25.9%)(均P<0.05)。多因素分析显示,最大囊肿直径较大、深部子宫内膜异位灶、r-AFS评分较高均为卵巢型子宫内膜异位症复发的危险因素(P<0.05),而术后用药、受孕皆为保护因素(P<0.05)。结论:诺雷德术后应用治疗效果更好,预防复发价值高;囊肿直径大、高r-AFS评分、深部子宫内膜异位灶卵巢型子宫内膜异位症患者术后复发风险大。Objective:To explore the effect of goserelin acetate sustained-release implant inserted or gestrinone used after laparoscopic surgery for treating patients with ovarian endometriosis,and to analyze the related factors of postoperative recurrence of endometriosis.Methods:170 patients with ovarian endometriosis who had undergone laparoscopic surgery were included and were divided into two groups(85 cases in each group)according to the random number table method from January 2016 to October 2020.The patients in the control group were treated with gestrinone for 4 to 6 consecutive cycles,and the patients in the observation group were treated with goserelin acetate sustained-release implant for 4 to 6 consecutive cycles.The therapeutic effect,the serum reproductive hormones levels,and the main symptoms of the patients were compared between the two groups.The incidence of adverse reactions and the recurrence rate within 1year of follow up of the patients in the two groups were counted.Logistic multivariate analysis was used to analyze the related influencing factors of the recurrence of ovarian endometriosis.Results:The total efficacy(90.6%)of the patients in the observation group was significantly higher than that(77.7%)of the patients in the control group.The decrease ranges of the reproductive hormone levels of the patients in the observation group after 6 months of treatment were significantly higher than those of the patients in the control group.The scores of dysmenorrhea,dyspareunia,and pelvic pain of the patients in the observation group were significantly lower than those of the patients in the control group(all P<0.05).The incidence of adverse reactions(18.8%)of the patients in the observation group had no significantly different from that(16.5%)of the patients in the control group(P>0.05).The endometriosis recurrence rate within 1 year after operation(8.2%)of the patients in the observation group was significantly lower than that(25.9%)of the patients in the control group(all P<0.05).Multivariate analysis sh

关 键 词：卵巢型子宫内膜异位症 腹腔镜手术 醋酸戈舍瑞林缓释植入剂 孕三烯酮 生殖激素 复发 危险因素 

分 类 号：R711.71[医药卫生—妇产科学]