摘要
目的探讨腹腔镜术后联合GnRH-a治疗子宫内膜异位症伴不孕的疗效及与r-AFS分期的相关性分析。方法106例子宫内膜异位症伴不孕患者经腹腔镜卵巢子宫内膜异位囊肿剔除、异位灶烧灼、粘连分离、输卵管整形及通液等手术治疗,术中行子宫内膜异位症的r-AFS分期,Ⅰ期21例,Ⅱ期25例,Ⅲ期36例,Ⅳ期24例,Ⅰ、Ⅱ期为轻度组,Ⅲ、Ⅳ为重度组。轻、重度组再分单纯腹腔镜手术治疗组和联合GnRH-a治疗组,并行随访1年的临床疗效比较,分析各组的症状缓解率、年复发率和妊娠率等情况。结果轻度子宫内膜异位症组的单纯腹腔镜手术治疗组的症状缓解率、年复发率和妊娠率与联合GnRH-a治疗组差别无显著性。重度子宫内膜异位症组的单纯腹腔镜手术治疗组的症状缓解率与联合GnRH-a治疗组差别无显著性。但年复发率及妊娠率差别有显著性。结论重度子宫内膜异位症组的腹腔镜手术治疗后有必要加用药物巩固治疗,GnRH-a巩固治疗的疗效明显优于单纯腹腔镜手术治疗,术后联合GnRH-a药物治疗可降低年复发率和提高妊娠率。
Objective To study the efficacy of Gonodotropine releasing hormone agonist plus laparoscopic surgery in endometriosis associated with infertility and the analysis in different subgroups of endometriosis. Methods One hundred and six cases with endometriosis and infertility who accepted laparoscopic surgery （LS）were divide into mild and severe groups according to r- AFS criteria for EMS, and followed up for 1 year. Moreover, two groups were divided into therapeutic subgroup （LS plus GnRH -a）and control subgroup （LS）. Data of remission, recurrence and pregnancy after treatment were collected and analyzed. Results There was no significant difference in the ratios of remission, recurrence and pregnancy between control and therapy subgroups in mild EMS group. The same results of remission happened to severe EMS group, however, a low ratio of recurrence and a high ratio of pregnancy were revealed. Conclusions It is necessary for patients with severe EMS group after LS to add endocrinal therapy. The effect of LS plus GnRH - a is prior to LS. LS plus GnRH - a may increase the pregnancy rate and decrease the recurrence rate in severe EMS.
出处
《医学信息（手术学分册）》
2007年第10期867-869,共3页
Medical Information Operations Sciences Fascicule
