摘要
目的探讨比较腹腔镜手术与促性腺激素释放激素激动剂(Gn RH-a)不同方式的联合应用对盆腔子宫内膜异位症(内异症)的疗效。方法 137例中、重度内异症患者,随机分为甲组(53例)、乙组(47例)和丙组(37例)。甲组患者术前术后各使用醋酸亮丙瑞林3个月;乙组患者直接行腹腔镜手术,根据术中情况术后使用醋酸亮丙瑞林3~6个月;丙组患者单纯行腹腔镜手术。比较三组术中情况及疗效。结果甲组手术时间、术后肛门排气时间均短于乙组和丙组,术中出血量少于乙组和丙组,差异具有统计学意义(P<0.05);乙组和丙组手术时间、术中出血量、术后肛门排气时间比较差异均无统计学意义(P>0.05)。术后随访1年,三组患者失访7例,随访率为94.89%。甲组和乙组治疗总有效率分别为96.23%、95.74%,均高于丙组的81.08%,差异具有统计学意义(P<0.05),甲、乙组两组治疗总有效率比较差异无统计学意义(P>0.05)。丙组无不良反应发生,甲组与乙组不良反应发生率均高于丙组,差异具有统计学意义(P<0.05),甲组与乙组不良反应发生率比较差异无统计学意义(P>0.05),多为用药期间潮热、盗汗和少量不规则阴道流血。甲组复发率均低于乙组和丙组,差异具有统计学意义(P<0.05)。结论术前使用Gn RH-a有利于手术的实施,腹腔镜手术联合使用Gn RH-a能有效抑制内异症复发。
Objective To investigate curative effect by laparoscopic surgery combined with gonadotropin releasing hormone agonist （GnRH-a） in the treatment of pelvic endometriosis. Methods A total of 137 patients with moderate and severe pelvic endometriosis were randomly divided into group A （53 cases）, group B （47 cases） and group C （37 cases）. Group A received preoperative and postoperative leuprolide acetate respectively for 3 months. Group B received laparoscopic surgery, followed by postoperative leuprolide acetate for 3～6 months. Group C received single laparoscopic surgery. Intraoperative condition and curative effect were compared in the three groups. Results Group A had shorter operation time, postoperative anal exhaust time, and less intraoperative bleeding volume than groups B and C. Their difference had statistical significance （P〈0.05）. There was no statistically significant difference of operation time, intraoperative bleeding volume and postoperative anal exhaust time between group B and group C （P〉0.05）. Postoperative 1-year follow-up showed 7 losing cases in the three groups, with follow-up rate as 94.89%. Group A and group B hadtotal effective rate in treatment respectively as 96.23% and 95.74%, which were both higher than 81.08% in group C, and their difference had statistical significance （P〈0.05）. There was no statistically significant difference of total effective rate in treatment between group A and group B （P〉0.05）. There was no case with adverse reactions in group C, while group A and group B all had higher incidence of adverse reactions than group C, and the difference had statistical significance （P〈0.05）. The difference between group A and group B of incidence of adverse reactions had no statistical significance （P〉0.05）. Main adverse reactions included hectic fever, night sweat and mild irregular vaginal bleeding during medication. Group A had lower recurrence rate than group B and group C, and their difference had statistical significance �
作者
吕莎
许晓晓
LYU Sha XU Xiao-xiao.(Department of Obstetrics and Gynecology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, Chin)
出处
《中国实用医药》
2017年第7期136-138,共3页
China Practical Medicine
