腹腔镜下个体化手术联合促性腺激素释放激素激动剂治疗子宫内膜异位症75例疗效观察

发布时间：2019-03-29 21:32

【摘要】：目的总结个体化腹腔镜手术与药物治疗子宫内膜异位症的疗效与经验。方法回顾性分析2007年1月-2011年12月该院腹腔镜手术治疗子宫内膜异位症患者75例,根据不同临床表现、治疗愿望及镜下所见情况,采用不同的手术治疗及药物治疗方案。所有患者随访12个月,观察生殖激素水平、不良反应及疗效等情况。结果随访12个月,失访2人,成功随访率为97.3%(73/75),完全缓解29例,缓解34例,无效10例;复发21例,受孕15例。治疗6个月后,患者FSH、LH、E2与PRL均下降,但只有FSH、LH与E2较术前明显下降,差异有显著性,P0.05。反向添加42例,对盗汗、潮热及睡眠不良患者,反向添加效果较好;而对阴道干涩、突破出血及关节疼痛效果不明显。结论腹腔镜手术后联合促性腺激素释放激素激动剂治疗子宫内膜异位症疗效较满意,值得临床推广应用。
[Abstract]:Objective to summarize the efficacy and experience of individualized laparoscopic surgery and drug therapy for endometriosis. Methods from January 2007 to December 2011, 75 patients with endometriosis were treated by laparoscopic surgery in our hospital. According to different clinical manifestations, treatment aspirations and the conditions seen under the microscope, different surgical and drug treatment schemes were adopted. All patients were followed up for 12 months to observe reproductive hormone level, adverse reaction and curative effect. Results after 12 months follow-up, the successful follow-up rate was 97.3% (73 / 75), complete remission in 29 cases, remission in 34 cases, ineffective in 10 cases, recurrence in 21 cases and pregnancy in 15 cases. After 6 months of treatment, both FSH,LH,E2 and PRL decreased, but only FSH,LH and E2 decreased significantly (P 0.05). In 42 patients with night sweating, hot tide and poor sleep, the effect of reverse addition was better than that on vaginal dryness, bleeding breakthrough and joint pain. Conclusion Laparoscopic surgery combined with gonadotropin-releasing hormone agonists is effective in the treatment of endometriosis and is worthy of clinical application.
【作者单位】：中南大学湘雅三医院;中南大学公共卫生学院;
【分类号】：R711.71

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