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目的:探讨腹腔镜手术联合术后药物治疗中、重度卵巢子宫内膜异位囊肿的疗效及安全性。方法:回顾性分析72例中重度卵巢子宫内膜异位囊肿患者的临床资料,所有患者均接受腹腔镜手术治疗,根据术后药物治疗情况分为3组,即诺雷德组(n=22),术后给予诺雷德治疗;孕三烯酮组(n=27),术后给予孕三烯酮治疗;对照组(n=23),术后未给予药物治疗。比较3组患者术后6个月后雌激素(E2)、卵泡刺激素(FSH)和黄体生成素(LH)的变化,术后症状改善情况。随访1年以上,比较3组患者妊娠率及复发率。结果:①诺雷德组、孕三烯酮组总有效率显著高于对照组(P<0.05),但诺雷德组与孕三烯酮组总有效率无显著差异,②诺雷德组、孕三烯酮组E2,LH,FSH,CA125,ALT,AST均显著低于对照组(P<0.05),并且诺雷德组E2低于孕三烯酮组,而ALT、AST均高于孕三烯酮组(P<0.05)。③所有患者均获得随访,3组患者平均随访时间无显著性差异(P>0.05),诺雷德组、孕三烯酮组妊娠率均高于对照组(P<0.05),但诺雷德组与孕三烯酮组妊娠率无显著差异(P>0.05)。诺雷德组复发率最低,孕三烯酮组复发率高于诺雷德组而低于对照组(P<0.05)。结论:相对腹腔镜手术治疗,术后诺雷德或孕三烯酮均可改善症状,降低复发率,提高妊娠率,且诺雷德降低复发率效果更好,但不良反应较多。
Objective: To investigate the efficacy and safety of laparoscopic surgery combined with postoperative drug treatment of moderate and severe ovarian endometriosis cysts. Methods: The clinical data of 72 patients with moderate or severe ovarian endometriosis were retrospectively analyzed. All patients underwent laparoscopic surgery. According to the postoperative medication, they were divided into 3 groups: norepinephrine group (n = 22) ). Noorect was given postoperatively. Gestrinone group (n = 27) was given gestrinone after the operation. In the control group (n = 23), no medication was given after the operation. The changes of estrogen (E2), follicle stimulating hormone (FSH) and luteinizing hormone (LH) and postoperative symptoms were compared between the three groups after 6 months. Follow-up more than 1 year, comparing the pregnancy rate and recurrence rate in 3 groups. Results: ① The total effective rate in Noread group and gestrinone group was significantly higher than that in control group (P <0.05), but there was no significant difference between Noread group and gestrinone group E2, LH, FSH, CA125, ALT, AST in Gestrinone group were significantly lower than those in control group (P <0.05), and E2 in Goretex group was lower than that in Gestrinone group Gestrinone group (P <0.05). All the patients were followed up, the average follow-up time of the three groups had no significant difference (P> 0.05). Pregnancy rates in Noread group and Gestrinone group were higher than those in control group (P <0.05) There was no significant difference in pregnancy rates between the group and Gestrinone (P> 0.05). The relapse rate was the lowest in Norodex group, the relapse rate in gestrinone group was lower than that in Noridex group (P <0.05). Conclusion: Laparoscopic surgery can improve the symptoms, reduce the recurrence rate and improve the pregnancy rate after Norel or Gestrinone treatment, and Noread’s effect of reducing the recurrence rate is better, but there are more adverse reactions.