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目的:探讨促性腺激素释放激素激动剂(GnRHa)联合曼月乐治疗中重度子宫内膜异位症(EMs)保守性手术后的疗效。方法:选择腹腔镜保守性手术后中重度EMs、无生育要求的患者43例,随机分为2组,试验组23例,术后使用GnRHa联合曼月乐治疗,对照组20例,术后单纯使用GnRHa治疗。随访12个月,比较手术前、手术后3个月、6个月、9个月和12个月疼痛评分、CA125值和复发率。结果:试验组和对照组中,术后各时间点的疼痛评分均低于术前(P<0.05);试验组中术后各时间点的疼痛评分无统计学差异;对照组中术后12个月疼痛评分均高于术后3个月、6个月和9个月(P<0.05);在术后12个月试验组的疼痛评分低于对照组(P<0.05)。试验组和对照组中,术后各时间点CA125值均低于术前(P<0.05);试验组中术后各时间点CA125值无统计学差异。对照组中术后12个月CA125值均显著高于术后3个月、6个月和9个月(P<0.05)。术后12个月试验组的CA125低于对照组(P<0.05)。试验组的复发率为0.0%;对照组的复发率为15.0%。结论:GnRHa联合曼月乐治疗保守性手术后中、重度EMs,可以长时间缓解疼痛,降低术后复发率,是一种有效的巩固治疗方法。
Objective: To investigate the efficacy of GnRHa combined with Mirena in the treatment of moderate-severe endometriosis (EMs) after conservative surgery. Methods: Forty-three patients with moderate to severe laparoscopic surgery after moderate-to-moderate laparoscopic surgery were enrolled in this study. They were randomly divided into two groups: 23 cases in trial group, GnRHa combined with Mirena L after operation and 20 cases in control group Use GnRHa treatment. The patients were followed up for 12 months. The pain score, CA125 value and recurrence rate before surgery, 3 months after surgery, 6 months, 9 months and 12 months were compared. Results: The pain scores of the experimental group and the control group at all time points after operation were all lower than those before operation (P <0.05). There was no significant difference in pain scores between the two groups Month pain scores were higher than 3 months, 6 months and 9 months after operation (P <0.05). Pain score of the experimental group was lower than that of the control group at 12 months after operation (P <0.05). In the test group and the control group, the CA125 values at all time points after operation were all lower than those before operation (P <0.05). There was no significant difference in CA125 between the two groups after operation. In the control group, the CA125 values at 12 months after operation were significantly higher than those at 3 months, 6 months and 9 months after operation (P <0.05). The level of CA125 in the experimental group at 12 months after operation was lower than that in the control group (P <0.05). The recurrence rate was 0.0% in the experimental group and 15.0% in the control group. Conclusions: GnRHa and Mirena are effective consolidation therapy for moderate and severe EMs after conservative operation, which can relieve pain for a long time and reduce postoperative recurrence rate.