宮—腹腔鏡術后輔以亮丙瑞林治療子宮內膜異位癥的臨床效果

付曉雯 姚麗艷 王虎 肖利珍

[摘要] 目的 探討宮-腹腔鏡術后輔以亮丙瑞林治療子宮內膜異位癥的臨床效果。 方法 選擇2015年9月～2016年6月新疆醫科大學第二附屬醫院術后確診為子宮內膜異位癥伴不孕的患者86例，根據不同治療方案分為兩組，對照組43例，采用宮-腹腔鏡手術治療；觀察組43例，在對照組基礎上術后月經周期應用亮丙瑞林治療，術后隨訪1年。比較兩組患者術后療效、妊娠結局、生活質量及雌二醇（E2）、糖類抗原125（CA125）水平。 結果 觀察組有效率高于對照組，復發率低于對照組，差異有統計學意義（P < 0.05）；觀察組的妊娠率高于對照組，差異有統計學意義（P < 0.05）；治療前兩組生活質量評分、視覺模擬評分、E2水平、CA125水平比較，差異無統計學意義（P > 0.05）；治療后，兩組患者治療后均較治療前明顯改善，差異均有統計學意義（P < 0.05）。 結論 宮腹腔鏡術后輔以亮丙瑞林治療子宮內膜異位癥伴不孕效果優于單純手術治療，一定程度上可降低復發率，提高子宮內膜異位癥不育患者的妊娠率，改善生活質量。

[關鍵詞] 宮-腹腔鏡；子宮內膜異位癥；亮丙瑞林；不孕

[中圖分類號] R711.71 [文獻標識碼] A [文章編號] 1673-7210（2018）03（b）-0084-04

The clinical effect of laparoscopy combined with hysteroscopy plus leuprorel in treatment of endometriosis

FU Xiaowen YAO Liyan WANG Hu XIAO Lizhen

Department of Gynecology and Obstetrics， the Second Affiliated Hospital of Xinjiang Medical University， Xinjiang Uygur Autonomous Region， Urumqi 830063， China

[Abstract] Objective To investigate the clinical effect in patients of endometriosis associated infertility after laparoscopy combined with hysteroscopy plus leuprorel in treatment. Methods From September 2015 to June 2016， 86 cases of endometriosis associated with infertility in the Second Affiliated Hospital of Xinjiang Medical University were selected， according to the different treatments they were divided into two groups： 43 cases in control group were given the treatment of laparoscopy combined with hysteroscopy treatment， 43 cases in the observation group were given the periodic injection of leuprorel on the basis of the control group. Postoperative follow-up of 1 years， the postoperative of pregnancy curative effect， postoperative life quality and estradiol （E2）， carbohydrate antigen （CA125） level of patients in the two groups were compared. Results The effective rate of the observation group was higher than that of the control group， and the recurrence rate was lower than that of the control group. the difference was statistically significant （P < 0.05）. The pregnancy rate of the observation group was better than that of the control group， and the difference was statistically significant （P < 0.05）. There was no significant difference in quality of life score， VAS score， and the level of E2 and CA125 between the two groups before treatment （P > 0.05）， and obviously improved after treatment， the differences were statistically significant （P < 0.05）. Conclusion Laparoscopy combined with hysteroscopy plus leuprorel treat endometriosis associated with infertility is better than simple surgery， and to a certain extent can reduce the recurrence rate， increase the pregnancy rate， and improve the quality of life of endometriosis.

[Key words] Laparoscopy combined with hysteroscopy； Endometriosis； Leuprorel； Sterility

子宮內膜異位癥（endometriosis，EMT）是指有功能的子宮內膜組織種植在子宮體以外的部位，其發病隱匿，屬于雌激素依賴性良性疾病，多發于育齡期女性，近年來發病率呈上升趨勢，常引起育齡婦女持續加重的盆腔疼痛、粘連及不孕等。25%～50%不孕婦女患有子宮內膜異位癥，子宮內膜異位癥患者不孕的發生率可高達40%左右[1]，因大多數子宮內膜異位癥患者有生育要求，難以接受根治性手術，故保留生育功能的宮-腹腔鏡聯合手術常作為臨床首選[2]，但也有研究指出，保留生育功能的腹腔鏡手術術后復發率高，單純的藥物治療效果也并不滿意[3]。本研究旨在探討宮-腹腔鏡術后輔以亮丙瑞林治療子宮內膜異位癥的臨床價值。……