摘要
目的探讨子宫内膜异位症患者的不同治疗方式对复发、妊娠的影响。方法选择行保守性手术患者共181例,依手术方式分为腹腔镜组和开腹组,依术后药物治疗分为术后未加用药物组(A组)、术后加用米作司酮组(B组)和术后加用诺雷德(GnRH-a)组(C组)。比较并分析各组之间复发及妊娠情况。结果开腹组患者复发率为31 4%,腹腔镜组患者复发率为27.8%,二者比较差异无统计学意义(P>0.05);开腹组妊娠率41.4%,明显低于腹腔镜组的62.8%,差异有统计学意义(P<0.05);开腹组平均受孕时间为13.3个月,明显长于腹腔镜组的9.5个月,差异有统计学意义(P<0.05)。在术后不同药物治疗患者中,各组复发率分别为A组44.1%,B组26.4%,C组12.2%,三组相比差异有统计学意义(P<0.05);各组妊娠率分别为A组32.4%,B组53.7%,C组69.2%,三组相比差异有统计学意义(P<0.05);A、B、C三组受孕时间相比差异没有统计学意义(P>0.05)。结论对于有生育要求的子宫内膜异位症患者,腹腔镜手术+术后诺雷德治疗可明显降低术后复发率,提高术后妊娠率并缩短受孕时间。
Objective To investigate the effects of different treatments to endometriosis on recurrence and pregnancy. Methods 181 patients with endometriosis who suffered from conservative surgery were divided into laparotomy group and laparoscope group. According to different postoperative medical treatments, they were divided into A, B, C groups. The patients were assigned not to receive any medical treatment in group A, to receive mifepristone in group B and to receive Zoladex （ GnRH - a） in group C. The recurrence rates and pregnancy rates of the three groups were compared and analysed. Results The recurrence rates of laparotomy group and laparoscope group were 31.4% and 27.8% respectively （P 〉 0. 05 ） ; The pregnancy rates of laparotomy group and laparoseope group were 41.4% and 62.8% respectively （P 〈 0. 05 ） ; The average time to pregnancy of laparotomy group was significant lower than that of laparoscopic surgery group （ 13.3 months vs 9.5 months,P 〈0.05 ）. In different medicine treatment groups after operation, the recurrence rates of group A, B and C were 44. 1%, 26.4% and 12.2% respectively （ P 〈 0. 05 ） ; The pregnancy rates of group A, B and C were 32. 4%, 53.7 % and 69.2% respectively （P 〈 0. 05 ） ; The average time to pregnancy of group A, B and C were not significantly different （P 〉 0. 05）. Conclusion The best treatment for patients with endometriosis who expect pregnancy is laparoscope surgery cooperated with Zoladex after operation, which can reduce the recurrence rate and the time to pregnancy and increase the pregnancy rate after operation.
出处
《中国医学创新》
CAS
2009年第23期4-6,共3页
Medical Innovation of China
