中国微创外科杂志
中國微創外科雜誌
중국미창외과잡지
CHINESE JOURNAL OF MINIMALLY INVASIVE SURGERY
2015年
4期
305-308
,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%临床疗效%妊娠率
子宮內膜異位癥%腹腔鏡%促性腺激素釋放激素激動劑%臨床療效%妊娠率
자궁내막이위증%복강경%촉성선격소석방격소격동제%림상료효%임신솔
Endometriosis%Laparoscopy%GnRH agonist%Clinical efficacy%Pregnancy rate
目的：探讨腹腔镜手术联合促性腺激素释放激素激动剂（ GnRH-a）治疗子宫内膜异位症的临床疗效。方法回顾性分析我院2008年1月～2012年1月行腹腔镜手术治疗的205例子宫内膜异位症患者资料，根据术后是否接受GnRH-a治疗及术后接受GnRH-a治疗的时间分成3组：A组单纯行腹腔镜手术（73例），B组术后亮丙瑞林治疗3个月（68例），C组术后亮丙瑞林治疗6个月（64例）。术后随访24个月，对比分析3组复发率及妊娠率。结果 B、C组1年内复发率分别为4．4％（3／68）、3．1％（2／64），均低于A组13．7％（10／73），C组显著低于A组（χ2＝4．771，P＝0．029），B组与A组差异无显著性（χ2＝3．628，P＝0．057）；B、C组累积复发率分别为13．2％（9／68）、10．9％（7／64），显著低于A组27．4％（20／73）（χ2＝4.322，P＝0．038；χ2＝5．839，P＝0．016）。3组术后2年内自然妊娠率差异无显著性（χ2＝0．812，P＝0．666），体外受精－胚胎移植（IVF-ET）妊娠者，B、C两组妊娠率[78．9％（15／19）、80．0％（16／20）]明显高于A组47．6％（10／21）（χ2＝4．177，P＝0.041；χ2＝4．630，P＝0．031）。结论腹腔镜联合GnRH-a治疗子宫内膜异位症疗效满意，可有效降低复发率，对腹腔镜术后行IVF-ET者于术后应用3～6个月GnRH-a可提高妊娠率。
目的：探討腹腔鏡手術聯閤促性腺激素釋放激素激動劑（ GnRH-a）治療子宮內膜異位癥的臨床療效。方法迴顧性分析我院2008年1月～2012年1月行腹腔鏡手術治療的205例子宮內膜異位癥患者資料，根據術後是否接受GnRH-a治療及術後接受GnRH-a治療的時間分成3組：A組單純行腹腔鏡手術（73例），B組術後亮丙瑞林治療3箇月（68例），C組術後亮丙瑞林治療6箇月（64例）。術後隨訪24箇月，對比分析3組複髮率及妊娠率。結果 B、C組1年內複髮率分彆為4．4％（3／68）、3．1％（2／64），均低于A組13．7％（10／73），C組顯著低于A組（χ2＝4．771，P＝0．029），B組與A組差異無顯著性（χ2＝3．628，P＝0．057）；B、C組纍積複髮率分彆為13．2％（9／68）、10．9％（7／64），顯著低于A組27．4％（20／73）（χ2＝4.322，P＝0．038；χ2＝5．839，P＝0．016）。3組術後2年內自然妊娠率差異無顯著性（χ2＝0．812，P＝0．666），體外受精－胚胎移植（IVF-ET）妊娠者，B、C兩組妊娠率[78．9％（15／19）、80．0％（16／20）]明顯高于A組47．6％（10／21）（χ2＝4．177，P＝0.041；χ2＝4．630，P＝0．031）。結論腹腔鏡聯閤GnRH-a治療子宮內膜異位癥療效滿意，可有效降低複髮率，對腹腔鏡術後行IVF-ET者于術後應用3～6箇月GnRH-a可提高妊娠率。
목적：탐토복강경수술연합촉성선격소석방격소격동제（ GnRH-a）치료자궁내막이위증적림상료효。방법회고성분석아원2008년1월～2012년1월행복강경수술치료적205례자궁내막이위증환자자료，근거술후시부접수GnRH-a치료급술후접수GnRH-a치료적시간분성3조：A조단순행복강경수술（73례），B조술후량병서림치료3개월（68례），C조술후량병서림치료6개월（64례）。술후수방24개월，대비분석3조복발솔급임신솔。결과 B、C조1년내복발솔분별위4．4％（3／68）、3．1％（2／64），균저우A조13．7％（10／73），C조현저저우A조（χ2＝4．771，P＝0．029），B조여A조차이무현저성（χ2＝3．628，P＝0．057）；B、C조루적복발솔분별위13．2％（9／68）、10．9％（7／64），현저저우A조27．4％（20／73）（χ2＝4.322，P＝0．038；χ2＝5．839，P＝0．016）。3조술후2년내자연임신솔차이무현저성（χ2＝0．812，P＝0．666），체외수정－배태이식（IVF-ET）임신자，B、C량조임신솔[78．9％（15／19）、80．0％（16／20）]명현고우A조47．6％（10／21）（χ2＝4．177，P＝0.041；χ2＝4．630，P＝0．031）。결론복강경연합GnRH-a치료자궁내막이위증료효만의，가유효강저복발솔，대복강경술후행IVF-ET자우술후응용3～6개월GnRH-a가제고임신솔。
Objective To evaluate the clinical efficacy of laparoscopic surgery combined with GnRH agonist in the treatment of endometriosis. Methods From January 2008 to January 2012, 205 patients with endometriosis underwent conservative laparoscopy surgery in our hospital .According to whether the patients accepted the therapy of GnRH-a and the time of the treatment after surgery, patients were divided into three groups:group A was treated with conservative laparoscopic surgical (73 cases), group B was given GnRH-a for 3 months after surgery (68 cases), and group C received GnRH-a for 6 months after surgery (64 cases).These patients were followed up for 24 months after surgery .The recurrence rate and pregnancy rate were compared among the three groups . Results The postoperative recurrence rates within one year were 4.4%(3/68) in the group B and 3.1% (2/64) in the group C, which were all lower than that of the group A (13.7%, 10/73).There was no difference between the group A and B (χ2 =3.628, P=0.057), while the rate of group C was significantly lower than that of the group A (χ2 =4.771, P=0.029).The cumulative recurrence rates in the group B and C were respectively 13.2%(9/68) and 10.9%(7/64), which were significantly lower than that of the group A [27.4%(20/73); χ2 =4.322, P=0.038; χ2 =5.839, P=0.016].There were no differences about the natural pregnancy rate within 2 years postoperatively among the three groups (χ2 =0.812, P=0.666), but for those who underwent IVF-ET after laparoscopy, the pregnancy rates in group B and C were respectively 78.9% (15/19) and 80.0% (16/20), which were significantly higher than that of the group A [47.6% (10/21); χ2 =4.177, P=0.041; χ2 =4.630, P=0.031]. Conclusions Laparoscopic surgery combined with GnRH-a is highly effective in the treatment of endometriosis , which can effectively reduce the recurrence rate .Application of GnRH-a for 3-6 months after laparoscopic surgery can improve the pregnancy rate in those who accept the treatment of IVF-ET.
