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目的探讨体质量对子宫内膜异位症保守性手术治疗患者术后用药疗效的影响。方法选取2014年1月-2016年1月该院收治的采用保守性手术治疗子宫内膜异位症60例患者为研究对象,按照体质量的不同分为低体质量组(38例)和高体质量组(22例)。所有患者术后均给予促性腺激素释放激素激动剂(GnRH-a)治疗,比较两组患者的治疗效果、治疗后的相关疼痛程度变化(痛经、慢性盆腔痛、性交痛)、性激素水平的变化。结果高体质量组治疗3个月后痛经评分、慢性盆腔痛评分、性交痛评分及性激素E_2、FSH及LH水平高于低体质量组。(P<0.05);两组停止治疗后6个月时的疼痛情况以及性激素水平比较差异无统计学意义(P>0.05)。高体质量组停止治疗后6个月时的总有效率低于低体质量组,复发率高于低体质量组,月经复潮时间短于低体质量组,差异均有统计学意义(均P<0.05)。结论 GnRH-a是保守性手术治疗子宫内膜异位症术后重要的辅助治疗方法,患者的体质量对术后GnRH-a的疗效有一定影响,在给予用药治疗时应结合患者的体质量给予个性化的治疗方案。
Objective To investigate the effect of body weight on the efficacy of postoperative medication in patients with conservative surgery for endometriosis. Methods From January 2014 to January 2016, 60 cases of endometriosis treated conservatively in our hospital were selected as the research object. According to their body weight, the patients were divided into low body weight group (38 cases) and high Body mass group (22 cases). All patients were given gonadotropin-releasing hormone agonist (GnRH-a) after operation. The therapeutic effect of the two groups of patients was compared. The changes of related pain degree (dysmenorrhea, chronic pelvic pain and painful sexual intercourse) and changes of sex hormone level . Results The dysmenorrheal scores, chronic pelvic pain scores, pain scores and sexual hormones E_2, FSH and LH in high body weight group were higher than those in low body weight group after 3 months of treatment. (P <0.05). There was no significant difference in pain and hormone levels between the two groups at 6 months after stopping treatment (P> 0.05). The total effective rate at 6 months after discontinuation of treatment in the high-body-weight group was lower than that of the low-body-weight group, the recurrence rate was higher than the low-body-weight group, the menstrual resurgence time was shorter than the low-body weight group, and the differences were statistically significant P <0.05). Conclusions GnRH-a is an important postoperative adjuvant therapy for conservative surgical treatment of endometriosis. The body weight of patients with GnRH-a has an impact on the efficacy of GnRH-a postoperatively, and should be combined with the body mass of patients Give personalized treatment options.