中国生化药物杂志
中國生化藥物雜誌
중국생화약물잡지
CHINESE JOURNAL OF BIOCHEMICAL PHARMACEUTICS
2014年
7期
108-110,113
,共4页
子宫内膜异位症%腹腔镜%促性腺激素释放激素激动剂%反向添加治疗
子宮內膜異位癥%腹腔鏡%促性腺激素釋放激素激動劑%反嚮添加治療
자궁내막이위증%복강경%촉성선격소석방격소격동제%반향첨가치료
endometriosis%laparoscope%gonadotropin-releasing hormone agonist%add-back therapy
目的：探讨腹腔镜术后应用促性腺激素释放激素激动剂（gonadotropin-releasing hormone agonist，GnRH-a）治疗子宫内膜异位症（endometriosis，EMs，简称内异症）的临床效果。方法选取2010年9月至2012年12月在宁波市北仑区人民医院行腹腔镜手术并明确诊断为子宫内膜异位症的158例患者为研究对象，分为3组：对照组行单纯腹腔镜手术，A组于腹腔镜手术后辅以GnRH-a类药物治疗，B组为术后辅以GnRH-a治疗后再给予反向添加治疗。通过比较分析治疗后各组总有效率、复发率、治疗前后激素水平变化及治疗后不良反应率等，从而评价不同治疗方法的临床效果。结果 A、B组治疗后总有效率（84.6％，86.2％）明显高于对照组（58.3％），差异有统计学意义（P＝0.032，P＝0.002），且复发率（15.4％，13.8％）低于对照组（41.6％），差异有统计学意义（P＝0.012，P＝0.001）。治疗后各组激素水平均明显降低。治疗后统计不良反应率，B组不良反应率明显较A组低，差异有统计学意义（P＝0.001）。结论内异症患者腹腔镜手术后辅助GnRH-a类药物治疗是目前比较安全、有效的治疗方式。术后GnRH-a类药物的应用能显著提高手术的总有效率，降低术后的复发率，但对长期使用GnRH-a类药物患者应给予反向添加治疗，可显著降低术后用药的不良反应，降低复发率或延缓复发，从而改善患者生活质量。
目的：探討腹腔鏡術後應用促性腺激素釋放激素激動劑（gonadotropin-releasing hormone agonist，GnRH-a）治療子宮內膜異位癥（endometriosis，EMs，簡稱內異癥）的臨床效果。方法選取2010年9月至2012年12月在寧波市北崙區人民醫院行腹腔鏡手術併明確診斷為子宮內膜異位癥的158例患者為研究對象，分為3組：對照組行單純腹腔鏡手術，A組于腹腔鏡手術後輔以GnRH-a類藥物治療，B組為術後輔以GnRH-a治療後再給予反嚮添加治療。通過比較分析治療後各組總有效率、複髮率、治療前後激素水平變化及治療後不良反應率等，從而評價不同治療方法的臨床效果。結果 A、B組治療後總有效率（84.6％，86.2％）明顯高于對照組（58.3％），差異有統計學意義（P＝0.032，P＝0.002），且複髮率（15.4％，13.8％）低于對照組（41.6％），差異有統計學意義（P＝0.012，P＝0.001）。治療後各組激素水平均明顯降低。治療後統計不良反應率，B組不良反應率明顯較A組低，差異有統計學意義（P＝0.001）。結論內異癥患者腹腔鏡手術後輔助GnRH-a類藥物治療是目前比較安全、有效的治療方式。術後GnRH-a類藥物的應用能顯著提高手術的總有效率，降低術後的複髮率，但對長期使用GnRH-a類藥物患者應給予反嚮添加治療，可顯著降低術後用藥的不良反應，降低複髮率或延緩複髮，從而改善患者生活質量。
목적：탐토복강경술후응용촉성선격소석방격소격동제（gonadotropin-releasing hormone agonist，GnRH-a）치료자궁내막이위증（endometriosis，EMs，간칭내이증）적림상효과。방법선취2010년9월지2012년12월재저파시북륜구인민의원행복강경수술병명학진단위자궁내막이위증적158례환자위연구대상，분위3조：대조조행단순복강경수술，A조우복강경수술후보이GnRH-a류약물치료，B조위술후보이GnRH-a치료후재급여반향첨가치료。통과비교분석치료후각조총유효솔、복발솔、치료전후격소수평변화급치료후불량반응솔등，종이평개불동치료방법적림상효과。결과 A、B조치료후총유효솔（84.6％，86.2％）명현고우대조조（58.3％），차이유통계학의의（P＝0.032，P＝0.002），차복발솔（15.4％，13.8％）저우대조조（41.6％），차이유통계학의의（P＝0.012，P＝0.001）。치료후각조격소수평균명현강저。치료후통계불량반응솔，B조불량반응솔명현교A조저，차이유통계학의의（P＝0.001）。결론내이증환자복강경수술후보조GnRH-a류약물치료시목전비교안전、유효적치료방식。술후GnRH-a류약물적응용능현저제고수술적총유효솔，강저술후적복발솔，단대장기사용GnRH-a류약물환자응급여반향첨가치료，가현저강저술후용약적불량반응，강저복발솔혹연완복발，종이개선환자생활질량。
Objective To observe clinical efficacy of laparoscopy combined with gonadotropin-releasing hormone agonist (GnRH-a ) in the treatment of endometriosis (EMs).Methods 158 patients who underwent laparoscopic surgery and were diagnosed endometriosis in our hospital during Sep.2010 to Dec.2010 were chosen and divided into three groups:control group were treated with pure laparoscopic surgery,group A were treated with laparoscopic surgery and follow-up GnRH-a medication,and group B were treated with laparoscopic surgery,follow-up GnTH-a medication and add-back therapy.The total effective rates,recurrence rates,the changes of hormone levels before and after the treatment and adverse reaction rates after treatment were compared and analyzed to evaluate the efficacy of different treatments.Results The total effective rates of group A and group B (84.6%,86.2%) were significantly higher than that of control group (58.3%),and the difference was statistically significant (P=0.032,P=0.032).The recurrence rates of group A and group B (15.4%,13.8%)were significantly reduced compared with that of control group (41.6%)(P=0.012,P=0.012).The hormone levels decreased dramatically after treatment in three groups.The adverse reaction rate of group B was apparently reduced compared with that of group A,and the difference was statistically significant (P=0.001 ).Conclusion Laparoscopy combined with GnRH-a medication was a safe and effective treatment for endometriosis.The application of GnRH-a after laparoscopy can significantly increase the total effective rate of the operation and reduce the postoperative recurrence rate.For the patients who need to take long-term GnRH-a treatment,add-back therapy need to be given to decrease its adverse reaction and recurrence rate,or to delay its recurrence,thus could improve patients' living qualities significantly.
