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目的探讨Ⅲ、Ⅳ期子宫内膜异位症腹腔镜手术治疗后加用不同药物巩固治疗的效果。方法 42例患者术后不用药(A组);46例加用孕三烯酮治疗(孕三烯酮2.5 mg,po,每周2次,疗程为6个月,B组);48例加用促性腺激素释放激素激动剂(GnRH-a)治疗(腹壁皮下注射诺雷得3.6 mg,每28天1次,疗程为6个月,C组)。比较3组患者术后缓解率、复发率、妊娠率及药物不良反应发生率。结果术后2 a症状缓解率3组比较差异无统计学意义(P>0.05),复发率A组高于B、C两组(P<0.05),而妊娠率B组及C组高于A组(P<0.05)。结论Ⅲ、Ⅳ期子宫内膜异位症腹腔镜手术治疗后加用药物巩固治疗,能明显提高妊娠率,降低复发率。
Objective To investigate the effect of consolidation therapy with different drugs after laparoscopic treatment of stage Ⅲ and Ⅳ endometriosis. Methods Forty-two patients were given no medication after operation (group A). Forty-six patients were treated with gestrinone (2.5 mg gestrinone, twice a week for 6 months, group B) Treatment with gonadotropin-releasing hormone agonist (GnRH-a) (Norley 3.6 mg subcutaneously every 28 days for 6 months, group C). The postoperative remission rate, recurrence rate, pregnancy rate and incidence of adverse drug reactions were compared between the three groups. Results There was no significant difference in symptom relief rate between the two groups (P> 0.05). The recurrence rate in group A was higher than that in group B and C (P <0.05), while the pregnancy rates in group B and C were higher than those in group A Group (P <0.05). Conclusion Stage Ⅲ, Ⅳ endometriosis after laparoscopic surgery combined with drug consolidation therapy can significantly improve the pregnancy rate and reduce the recurrence rate.