糖皮质激素联合醋酸戈舍瑞林对子宫内膜异位症患者腹腔镜术后妊娠率的影响  

Effect of glucocorticoids combined with goserelin acetate on the pregnancy rate of patients with endometriosis after laparoscopic surgery

作　　者：冯英 王玉梅 Feng Ying;Wang Yumei(Department of Obstetrics and Gynecology,Nanyang Longhai Hospital,Nanyang,Henan 473000,China;Department of Obstetrics and Gynecology,Hangzhou Xihu Cunji Hospital,Hangzhou,Zhejiang 310000,China)

机构地区：[1]南阳陇海医院妇产科,河南南阳473000 [2]杭州西湖存济医院妇产科,浙江杭州310000

出　　处：《中国药物与临床》2024年第7期460-464,共5页Chinese Remedies & Clinics

摘　　要：目的探讨糖皮质激素联合醋酸戈舍瑞林对子宫内膜异位症患者腹腔镜术后妊娠率的影响。方法根据治疗方法,将在2022年1月至2023年1月于南阳陇海医院就诊的83例子宫内膜异位症患者分为对照组41例和观察组42例。2组均在经期过后5~7 d行腹腔镜手术切除病灶,术后对照组皮下注射醋酸戈舍瑞林,观察组则在以上基础上加用甲泼尼龙片口服,2组均连续治疗6个月。比较2组临床疗效(临床症状、体征及盆腔肿块情况),治疗前后激素水平(雌二醇、促卵泡生成素、黄体生成素、血管内皮生长因子)与术前和术后第3天炎性因子(C反应蛋白、肿瘤坏死因子-α、白细胞介素-2)水平,以及妊娠与复发情况。结果经治疗观察组疗效更佳(P<0.05)。经治疗2组雌二醇、促卵泡生成素、黄体生成素、血管内皮生长因子水平均降低,观察组相对降幅更大(P<0.05)。与术前比较,术后第3天2组C反应蛋白、肿瘤坏死因子-α、白细胞介素-2水平均升高,观察组相对升幅更小(P<0.05)。经治疗观察组妊娠率更高,复发率更低(P<0.05)。结论糖皮质激素联合醋酸戈舍瑞林在子宫内膜异位症中具有明显的治疗效果,可有效调节患者激素水平,改善炎性反应,且对提高患者妊娠率、降低疾病复发率均有突出效果。Objective To explore the effect of glucocorticoids combined with noride on the pregnancy rate of patients with endometriosis after laparoscopic surgery.Methods According to the random number table method,a total of 83 patients with endometriosis who visited Nanyang Longhai Hospital from January 2022 to Jan-uary 2023 were divided into a control group(41 cases)and an observation group(42 cases).Both groups under-went laparoscopic surgery to remove the lesions 5~7 days after menstruation.After surgery,the control group re-ceived subcutaneous injection of goserelin acetate,while the observation group received oral methylprednisolone tablets in addition to the above.Both groups were treated continuously for six months.The clinical efficacy(clini-cal symptoms,signs,and pelvic mass condition),hormone levels(estradiol,follicle stimulating hormone,luteinizing hormone,vascular endothelial growth factor)before and after treatment,and inflammatory factors(C-reactive pro-tein,tumor necrosis factor-α,interleukin-2)levels before and on the third day after surgery,as well as pregnancy and recurrence status were compared between the two groups.Results After treatment,the efficacy in the obser-vation group was better(P<0.05).The levels of estradiol,follicle-stimulating hormone,luteinizing hormone,and vascular endothelial growth factor in both groups were significantly reduced after treatment,and the relative reduc-tion in the observation group was greater(P<0.05).Compared with preoperative,the levels of C-reactive protein,tumor necrosis factor-α,and interleukin-2 in both groups were significantly increased on the 3rd day after surgery,while the relative increase in the observation group was smaller(P<0.05).The pregnancy rate was higher and the recurrence rate was lower in the observation group after treatment(P<0.05).Conclusion The combination of glu-cocorticoids and goserelin acetate has a significant therapeutic effect on endometriosis,which can effectively regu-late hormone levels in patients,improve inflammatory reactions,an

关 键 词：子宫内膜异位症 糖皮质激素类 戈舍瑞林 妊娠率 

分 类 号：R713.4[医药卫生—妇产科学]