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目的:探讨子宫内膜异位症腹腔镜术后应用曲普瑞林和孕三烯酮的临床疗效、复发率、妊娠率、药物副反应情况。方法:选择腹腔镜保守性手术治疗子宫内膜异位症120例,随机分为三组:曲普瑞林组、孕三烯酮组、未用药对照组;疗程6个月,随访24个月,比较三组临床疗效、复发率、妊娠率,副反应发生情况。结果:曲普瑞林组与孕三烯酮组体征缓解率、妊娠率均明显高于未用药对照组;复发率均明显低于对照组,差异具有统计学意义(P<0.05)。而用药组之间的缓解率、妊娠率、复发率无明显差异(P>0.05)。用药组的不同副反应发生率各异,曲普瑞林组以低雌激素副反应为主,孕三烯酮组以肝功能损害、体重增加最常见,差异有统计学意义(P<0.05)。结论:子宫内膜异位腹腔镜术后联合药物治疗效果良好,对降低复发率、提高妊娠率有重要意义。
Objective: To investigate the clinical efficacy, relapse rate, pregnancy rate and drug side effects of triptorelin and gestrinone after laparoscopic surgery for endometriosis. Methods: One hundred and twenty cases of endometriosis were treated by laparoscopic conservative surgery. The patients were randomly divided into three groups: triptorelin group, gestrinone group and non-medication control group. The course of treatment was 6 months and followed up for 24 months The clinical efficacy, relapse rate, pregnancy rate and side effects of the three groups were compared. Results: The remission rate and pregnancy rate in triptorelin group and gestrinone group were significantly higher than those in non-medication control group. The recurrence rates were significantly lower than those in control group (P <0.05). There was no significant difference in remission rate, pregnancy rate and recurrence rate between the two groups (P> 0.05). There were different incidences of side effects in the treatment group. The low-estrogen side-effects in the triptorelin group were the major ones. The hepcidin in the gestrinone group was the most common and the difference was statistically significant (P <0.05) . Conclusions: The combined treatment of endometriosis and laparoscopy has a good effect on reducing the recurrence rate and increasing the pregnancy rate.