CAJ | 학술논문

目的：探讨GnRH-a辅助下腹腔镜双侧卵巢子宫内膜异位囊肿剔除术的临床疗效及对再妊娠的影响。方法随机选取双侧卵巢子宫内膜异位囊肿患者64例,随机分为干预组34例和常规组30例,干预组给予GnRH-a 3.75 mg 注射治疗2 w,随后再行腹腔镜下子宫内膜异位囊肿剔除术；常规组不给予任何预处理直接行腹腔镜手术治疗,比较两组治疗后性激素水平、卵巢直径的变化,随访1年,比较再妊娠情况和囊肿复发情况。结果干预组患者FSH水平为(8.03±2.11) mIU /mL,明显低于常规组,而E2和LH水平均高于常规组,差异具有统计学意义(P<0.05)；常规组卵巢直径≤2 cm占67.65%,卵巢体积明显缩小,随访1年,干预组囊肿复发率为5.88%,再妊娠率为63.63%,且术后妊娠间隔间隔时间缩短,与对照组比较差异具有统计学意义(P<0.05)。结论腹腔镜双侧卵巢子宫内膜异位囊肿剔除术术前应用GnRH-a治疗可有效减轻对卵巢储备功能的影响,对有生育要求的患者尽可能有效地保护了卵巢功能。
목적：탐토GnRH-a보조하복강경쌍측란소자궁내막이위낭종척제술적림상료효급대재임신적영향。방법수궤선취쌍측란소자궁내막이위낭종환자64례,수궤분위간예조34례화상규조30례,간예조급여GnRH-a 3.75 mg 주사치료2 w,수후재행복강경하자궁내막이위낭종척제술；상규조불급여임하예처리직접행복강경수술치료,비교량조치료후성격소수평、란소직경적변화,수방1년,비교재임신정황화낭종복발정황。결과간예조환자FSH수평위(8.03±2.11) mIU /mL,명현저우상규조,이E2화LH수평균고우상규조,차이구유통계학의의(P<0.05)；상규조란소직경≤2 cm점67.65%,란소체적명현축소,수방1년,간예조낭종복발솔위5.88%,재임신솔위63.63%,차술후임신간격간격시간축단,여대조조비교차이구유통계학의의(P<0.05)。결론복강경쌍측란소자궁내막이위낭종척제술술전응용GnRH-a치료가유효감경대란소저비공능적영향,대유생육요구적환자진가능유효지보호료란소공능。
Objective To investigate the curative effects of GnRH-a assisted laparoscopic resection for bilateral ovarian endome-triosis cyst and its influence on the second pregnancy. Methods 64 cases of bilateral ovarian endometriosis cyst were randomly select-ed and divided into the intervention group (n=34) and the conventional group (n=30). The intervention group was given GnRH-a 3. 75 mg injection for 2 weeks, then underwent laparoscopic excision for endometriosis cyst, while the conventional group was not giv-en any pretreatment and simply given laparoscopic surgical treatment, then the change of hormone levels and ovarian diameters were compared between the two groups after treatment, and both group received the follow-up for 1 year, then the pregnancy and cyst re-currence were compared. Results The FSH level of the intervention group were (8. 03+2. 11) mIU /mL, significantly lower than the conventional group, while the E2 and LH levels were higher than conventional group with significant difference (P<0. 05), normal o-vary diameter less than 2 cm accounted for 67. 65%, and ovarian volume was significantly reduced; after 1 year of follow-up, the cyst recurrence rate of the intervention group was 5. 88%, pregnancy rate was 63. 63%, and the postoperative pregnancy interval in-terval time was shortened with statistically significant difference compared with the conventional group (P<0. 05). Conclusion Appli-cation of GnRH-a before laparoscopic bilateral ovarian endometriosis cyst surgery can effectively reduce the influence on the ovarian re-serve function as much as possible and effectively protect the ovarian function for the patients who have the reproduction requirements.