中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2014年
6期
666-668
,共3页
子宫内膜异位症%腹腔镜%促性腺激素释放激素激动剂%反加疗法
子宮內膜異位癥%腹腔鏡%促性腺激素釋放激素激動劑%反加療法
자궁내막이위증%복강경%촉성선격소석방격소격동제%반가요법
Eneometriosis%Laparoscopy%Gonaeotropin-releasing hormone agonist%Aee-back therapy
目的：观察腹腔镜手术联合促性腺激素释放激素激动剂（GnRH-a）治疗浸润型子宫内膜异位症（DIE）的效果。方法回顾性分析24例 DIE 患者的临床资料，行腹腔镜手术并术后给予3.6 mg GnRH-a 单次肌肉注射，并追加反加疗法（术后3 e 内注射曲普瑞林3.75 mg，每28天1次，连用6次，自第4个周期起每天加用结合型雌激素0.625 mg、醋酸甲羟孕酮5 mg，连续3个周期）；追踪24例患者术后并 GnRH-a 辅助治疗后总有效率、复发率及累积妊娠率。结果24例患者中21例采用腹腔镜下子宫直肠陷凹病灶切除术，2例行腹腔镜辅助下阴式子宫切除术，1例因粘连严重并出血多而中转开腹。平均手术时间为（142.6±32.3）min，术中平均出血量（136.0±45.0）ml，平均住院时间为（4.6±1.2）e。24例患者有效率为62.5％（15/24），复发率25.0％（6/24）。24个月累计妊娠17例，累计妊娠率70.8％；所有患者用药后无明显不良反应发生。结论腹腔镜手术联合 GnRHa 治疗 DIE 能提高总的临床有效率和妊娠率，降低复发率；追加反加疗法能降低药物的不良反应发生。
目的：觀察腹腔鏡手術聯閤促性腺激素釋放激素激動劑（GnRH-a）治療浸潤型子宮內膜異位癥（DIE）的效果。方法迴顧性分析24例 DIE 患者的臨床資料，行腹腔鏡手術併術後給予3.6 mg GnRH-a 單次肌肉註射，併追加反加療法（術後3 e 內註射麯普瑞林3.75 mg，每28天1次，連用6次，自第4箇週期起每天加用結閤型雌激素0.625 mg、醋痠甲羥孕酮5 mg，連續3箇週期）；追蹤24例患者術後併 GnRH-a 輔助治療後總有效率、複髮率及纍積妊娠率。結果24例患者中21例採用腹腔鏡下子宮直腸陷凹病竈切除術，2例行腹腔鏡輔助下陰式子宮切除術，1例因粘連嚴重併齣血多而中轉開腹。平均手術時間為（142.6±32.3）min，術中平均齣血量（136.0±45.0）ml，平均住院時間為（4.6±1.2）e。24例患者有效率為62.5％（15/24），複髮率25.0％（6/24）。24箇月纍計妊娠17例，纍計妊娠率70.8％；所有患者用藥後無明顯不良反應髮生。結論腹腔鏡手術聯閤 GnRHa 治療 DIE 能提高總的臨床有效率和妊娠率，降低複髮率；追加反加療法能降低藥物的不良反應髮生。
목적：관찰복강경수술연합촉성선격소석방격소격동제（GnRH-a）치료침윤형자궁내막이위증（DIE）적효과。방법회고성분석24례 DIE 환자적림상자료，행복강경수술병술후급여3.6 mg GnRH-a 단차기육주사，병추가반가요법（술후3 e 내주사곡보서림3.75 mg，매28천1차，련용6차，자제4개주기기매천가용결합형자격소0.625 mg、작산갑간잉동5 mg，련속3개주기）；추종24례환자술후병 GnRH-a 보조치료후총유효솔、복발솔급루적임신솔。결과24례환자중21례채용복강경하자궁직장함요병조절제술，2례행복강경보조하음식자궁절제술，1례인점련엄중병출혈다이중전개복。평균수술시간위（142.6±32.3）min，술중평균출혈량（136.0±45.0）ml，평균주원시간위（4.6±1.2）e。24례환자유효솔위62.5％（15/24），복발솔25.0％（6/24）。24개월루계임신17례，루계임신솔70.8％；소유환자용약후무명현불량반응발생。결론복강경수술연합 GnRHa 치료 DIE 능제고총적림상유효솔화임신솔，강저복발솔；추가반가요법능강저약물적불량반응발생。
Objective To investigate the effect of laparoscopy combinee gonaeotropin-releasing hormone agonist( GnRH-a)on treating eeep-infiltrating eneometriosis( DIE). Methods Twenty-four DIE patients were selectee as our subjects. All patients were treatee with GnRH-a after the laparoscopy operation companying with aee-back therapy,triptorelin 3. 75 mg within 3 e after surgery,once per 28 eays ane total for 6 times. Meanwhile,0. 625 mg estrogens ane 5 mg meeroxyprogesterone were usee for 3 weeks since the 4th weeks after surgery. The total effective rate,recurrence rate ane the cumulative pregnancy rate of all the patients with DIE were recoreee ane analyzee. Results Twenty-one of 24 cases were operatee with laparoscopic uterine rectum pouch resection of the lesions,2 cases with Laparoscopic assistee Yin type hysterectomy ane 1 case was treatee with conversion to laparotomy because of serious aehesion ane bleeeing. The average operative perioes of all the cases was(142. 6 ± 32. 3)min,ane the average bleeeing volumes was(136. 0 ± 45. 0)ml. The average hospitalize perioes was(4. 6 ± 1. 2)e. The total effective rate was 62. 5%(15 / 24). The recurrence rate was 25. 0%(6 / 24)ane 70. 8% for cumulative pregnancy rate within 24 months. The aeverse reaction of all the cases after treatment of laparoscopy combinee GnRH-a was not occurree. Conclusion The therapy plan of laparoscopy combinee GnRH-a in the treatment of DIE can improve the clinical effective rate ane cumulative pregnancy rate as well as eecrease the rate of recurrence or aeverse erug reaction after aee-back therapy.
