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:探讨腹腔镜与促性腺激素释放激素激动剂(Gn RH-a)联合治疗子宫内膜异位症(EMS)伴不孕症的临床疗效。方法:选择2012年1月~2014年12月期间我院收治的108例EMS伴不孕症患者作为研究对象,随机分为研究组与对照组,每组各54例。对照组患者采用腹腔镜治疗,研究组在此基础上于术后应用达菲林治疗。两组均行宫腔镜检查,观察两组临床疗效,1年内的妊娠率、复发率及两组患者治疗前后血浆雌二醇(E2)及卵泡刺激素(FSH)水平变化。结果:研究组治疗总有效率为98.15%,显著高于对照组的85.19%(P0.05);两组1年内复发率对比差异无统计学意义(P0.05);研究组1年内妊娠率为55.56%,高于对照组的27.78%(P0.05)。研究组治疗后E2、FSH显著低于对照组及治疗前(P0.05)。结论:腹腔镜联合Gn RH-a治疗EMS伴不孕症应用效果显著,可以有效改善患者的临床症状,提高妊娠率。

Curative Effect Observation of Laparoscopic Combined with Gonadotropin-Releasing Hormone Agonist in the Treatment of Endometriosis with Barrenness

ABSTRACT Objective: To study the curative effect of laparoscopic combined with Gonadotropin-releasing hormone agonist(GnRH-a)in the treatment of endometriosis(EMS)with barrenness. Methods: Selected 108 cases of patients with EMS with barrenness who were treated in our hospital from January 2012 to December 2014 as research object, and were randomly divided into study group and control group, with 54 cases of patients in each group. The patients in the control group were treated with laparoscopic, and the pa- tients in study group were treated with diphereline on the basis of control group after operation. Observed the clinical efficacy of patients in two groups, pregnancy rate and recurrence rate in 1 year, and the changes of plasma estradiol-2 (E2)and follicle stimulating hormone(FSH)levels of patients in the two groups before and after treatment. Results: The total effective rate in treated of the study group was 98.15%, which was significantly higher than 85.19% of the control group(P<0.05), compared of recurrence rate in 1 year in the two groups the difference was not statistically significant(P>0.05), the pregnancy rate in 1 year of the study group was 55.56%, which was significantly higher than 27.78% of the control group(P<0.05). After treatment, the E2, FSH in the study group were significantly lower than those in the control group and before treatment(P<0.05). Conclusion: laparoscopic combined with GnRH-a in the treatment of EMS with barrenness has significant effect, can effectively improve the patients clinical symptoms, increase pregnancy rate.