腹腔镜联合促性腺激素释放激素激动剂治疗子宫内膜异位症伴不孕症的疗效观察

目的:探讨腹腔镜联合促性腺激素释放激素激动剂治疗子宫内膜异位症伴不孕症的疗效。方法:将我院2013年2月~2014年2月收治的200例子宫内膜异位症伴不孕症患者随机分为2组各100例,对照组采用曲普瑞林治疗,观察组采用腹腔镜联合曲普瑞林治疗,检测患者治疗前后血清雌二醇(E2)、癌胚抗原125(CA125)及基质金属蛋白酶-1(MMP-1)水平,对比两组治疗后疼痛视觉评分(VAS)、盆腔包块和用药停止后月经恢复情况、随访1年记录两组复发率及妊娠率。结果:治疗后观察组VAS评分、盆腔包块和月经恢复情况均明显优于对照组,差异有统计学意义(P0.05);两组患者血清CA125、E2及MMP-1水平均显著下降,且观察组下降更明显,差异有统计学意义(P0.05);随访1年后,观察组妊娠率明显高于对照组,复发率明显低于对照组,差异有统计学意义(P0.05)。结论:腹腔镜联合促性腺激素释放激素激动剂治疗子宫内膜异位症的疗效显著,能有效降低复发率、提高妊娠率,值得临床推广应用。

Effect of Laparoscopy Combined with Gonadotropin Releasing HormoneAgonist in the Treatment of Endometriosis with Infertility

Objective:To investigate the effect of laparoscopy combined with gonadotropin releasing hormone agonist in the treatmentof endometriosis associated with infertility.Methods:200 cases of patients with endometriosis with infertility who treated in ourhospital from February 2013 to February 2014 were randomly divided into 2 groups with 100 cases in each group, the control group weretreated with triptorelin, observation group were treated with laparoscopy combined with triptorelin, Serum estradiol (E2), cancer antigen125 (CA125) and matrix metalloproteinase -1 (MMP-1) levels were detected before and after treatment. The pain visual score (VAS),pelvic mass and medication were compared between the two groups, and the recurrence rate and pregnancy rate of two groups wererecorded after 1 years of follow-up.Results:After treatment, the VAS score, pelvic mass and menstrual recovery of the observation groupwere significantly better than that of the control group, the difference was statistically significant (P<0.05); The levels of serum CA125,E2 and MMP-1 were significantly decreased in the two groups, and the observation group was significantly decreased, the difference wasstatistically significant (P<0.05). After 1 years of follow-up, the pregnancy rate in observation group was significantly higher than that inthe control group, the recurrence rate was significantly lower than that of the control group, the difference was statistically significant(P<0.05).Conclusion:Laparoscopic combined with gonadotropin releasing hormone agonist treatment of endometriosis with infertilitycan improve the curative effect, reduce the recurrence rate, improve pregnancy rate, which is worthy of clinical application.