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目的观察卵巢巧克力囊肿患者腹腔镜术后应用促性腺激素释放激素拮抗剂(GnRHa)的疗效及安全性。方法选择2010年6月—2015年6月收治的卵巢巧克力囊肿患者90例,随机分为对照组及观察组。两组均行腹腔镜下卵巢巧克力囊肿剥除术;观察组术后第1次月经来潮第2天即给予GnRHa 3.75 mg肌内注射,28 d注射1次,连续注射6次。随访1年,采用免疫化学发光法检测两组黄体生成素(luteinizing hormone,LH)、卵泡雌激素(follicular estrogen,FSH)、孕酮(progesterone,P)、雌二醇(estradiol,E_2)水平;比较两组疗效、1年内复发情况、不良反应发生率。计量资料比较采用t检验,计数资料比较采用χ~2检验,P<0.05为差异有统计学意义。结果观察组LH、FSH[(12.44±1.61)、(28.49±2.83)m U/m L]高于对照组[(9.73±2.53)、(15.39±3.56)m U/m L],P、E_2[(1.53±2.33)、(41.39±0.56)pmol/L]低于对照组[(2.83±3.72)、(69.28±0.51)pmol/L],比较差异有统计学意义(均P<0.05)。观察组总有效率为97.83%,高于对照组(81.82%),比较差异有统计学意义(P<0.05)。观察组1年内复发1例,对照组6例,比较差异有统计学意义(P<0.05)。观察组术后不良反应发生率与对照组比较差异无统计学意义(P>0.05)。结论卵巢巧克力囊肿患者腹腔镜术后应用GnRHa疗效好,安全性高。
Objective To observe the efficacy and safety of gonadotropin-releasing hormone antagonist (GnRHa) after laparoscopic surgery in patients with ovarian chocolate cyst. Methods 90 patients with ovarian chocolate cyst admitted from June 2010 to June 2015 were randomly divided into control group and observation group. Laparoscopic ovarian chocolate cyst excision was performed in both groups. In the observation group, intramuscular injection of GnRHa 3.75 mg was given on the second day after the first menstrual cramp, once a day for 28 days and continuous injection for 6 times. The levels of luteinizing hormone (LH), follicular estrogen (FSH), progesterone (P) and estradiol (E 2) in the two groups were detected by immunochemical chemiluminescence. The curative effect of two groups were compared, the recurrence within one year and the incidence of adverse reactions. Measurement data were compared using t test, count data were compared using χ ~ 2 test, P <0.05 for the difference was statistically significant. Results The levels of LH, FSH [(12.44 ± 1.61) and (28.49 ± 2.83) m U / m L] in the observation group were significantly higher than those in the control group [(9.73 ± 2.53) and (15.39 ± 3.56) [(1.53 ± 2.33) and (41.39 ± 0.56) pmol / L] were lower than those in the control group [(2.83 ± 3.72) and (69.28 ± 0.51) pmol / L, respectively. The total effective rate in observation group was 97.83%, which was higher than that in control group (81.82%), the difference was statistically significant (P <0.05). In the observation group, 1 case relapsed in 1 year and 6 cases in the control group, the difference was statistically significant (P <0.05). There was no significant difference in the incidence of postoperative adverse reactions between the observation group and the control group (P> 0.05). Conclusions GnRHa is effective and safe in patients with ovarian chocolate cyst after laparoscopic operation.