[1]张译心,王秀美,薛晓玲.促性腺激素释放激素激动剂对保守性腹腔镜手术后卵巢子宫内膜异位症患者疼痛及生殖激素水平的影响[J].新乡医学院学报,2019,36(8):785-788.[doi:10.7683/xxyxyxb.2019.08.020]
　ZHANG Yi-xin,WANG Xiu-mei,XUE Xiao-ling.Effects of gonadotropin releasing hormone agonists on pain and reproductive hormone levels in patients with ovarian endometriosis after conservative laparoscopic surgery[J].Journal of Xinxiang Medical University,2019,36(8):785-788.[doi:10.7683/xxyxyxb.2019.08.020]
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促性腺激素释放激素激动剂对保守性腹腔镜手术后卵巢子宫内膜异位症患者疼痛及生殖激素水平的影响
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
36
期数:
2019年8
页码:
785-788
栏目:
临床研究
出版日期:
2019-08-05

文章信息/Info

Title:
Effects of gonadotropin releasing hormone agonists on pain and reproductive hormone levels in patients with ovarian endometriosis after conservative laparoscopic surgery
作者:
张译心; 王秀美; 薛晓玲
（海安市人民医院妇产科，江苏　海安　226600）
Author(s):
ZHANG Yi-xin; WANG Xiu-mei; XUE Xiao-ling
(Department of Obstetrics and Gynecology,Haian People′s Hospital,Haian 226600,Jiangsu Province,China)
关键词:
卵巢子宫内膜异位症; 腹腔镜手术; 促性腺激素释放激素激动剂; 生殖激素
Keywords:
ovarian endometriosis; laparoscopic operation; gonadotropin releasing hormone agonist; reproductive hormone
分类号:
R711.71
DOI:
10.7683/xxyxyxb.2019.08.020
文献标志码:
A
摘要:
目的　探讨促性腺激素释放激素激动剂（GnRH-α）对保守性腹腔镜手术后卵巢子宫内膜异位症患者疼痛及生殖激素水平的影响。方法　选择2014年6月至2017年9月于海安市人民医院行保守性腹腔镜手术的70例卵巢子宫内膜异位症患者作为研究对象，根据患者术后药物治疗方法分为观察组和对照组，每组35例。对照组患者术后给予孕三烯酮治疗，观察组患者术后采用GnRH-α治疗，共治疗6个月。观察2组患者治疗后性交痛、痛经、盆腔痛缓解情况及治疗过程中不良反应发生情况，对2组患者治疗前后血清促卵泡激素（FSH）、黄体生成素（LH）、雌二醇（E2）、催乳素（PRL）水平进行比较，治疗后根据患者症状改善情况及超声检查结果评定临床疗效。结果　治疗期间，观察组和对照组患者不良反应发生率分别为28.6%（10/35）、34.3%（12/35），2组患者不良反应发生率比较差异无统计学意义（χ2=0.265，P>0.05）。2组患者停药后不良反应逐渐消失，未对患者产生严重影响。治疗后，观察组患者性交痛缓解率、痛经缓解率、盆腔痛缓解率分别为100.0%（4/4）、96.2%（25/26）、97.1%（33/34），对照组患者性交痛缓解率、痛经缓解率、盆腔痛缓解率分别为66.7%（2/3）、61.5%（16/26）、56.3%（9/16）；观察组患者痛经缓解率、盆腔痛缓解率显著高于对照组（χ2=9.339、13.482，P<0.05），2组患者性交痛缓解率比较差异无统计学意义（χ2=1.556，P>0.05）。治疗前2组患者血清E2、FSH、PRL及LH水平比较差异均无统计学意义（P>0.05）；2组患者治疗后血清E2、FSH、PRL及LH水平低于治疗前（P<0.05）；治疗后，观察组患者血清E2、FSH、PRL及LH水平低于对照组（P<0.05）。观察组患者治疗痊愈率、有效率、无效率、复发率、总有效率分别为51.4%（18/35）、37.1%（13/35）、5.7%（2/35）、5.7%（2/35）、88.6%（31/35），对照组患者治疗痊愈率、有效率、无效率、复发率、总有效率分别为25.7%（9/35）、48.6%（17/35）、11.4%（4/35）、14.3%（5/35）、74.3%（26/35）；观察组患者痊愈率高于对照组（χ2=4.883，P<0.05），但2组患者有效率、无效率、复发率及总有效率比较差异无统计学意义（χ2=0.933、0.729、1.428、2.362，P>0.05）。结论　卵巢子宫内膜异位症腹腔镜手术后给予GnRH-α治疗，能够改善患者疼痛及生殖激素水平，降低复发率，提高临床疗效，且安全性好。
Abstract:
Objective　To investigate the effect of gonadotropin releasing hormone agonist (GnRH-α) on pain and reproductive hormone levels in patients with ovarian endometriosis after conservative laparoscopic surgery.Methods　Seventy patients with ovarian endometriosis who underwent conservative laparoscopic surgery in Haian People′s Hospital from June 2014 to September 2017 were selected as the study subjects,and they were divided into observation group and control group according to the drug treatment after operation,with 35 cases in each group.The patients in the control group were treated with gestrinone,and the patients in the observation group were treated with GnRH-α for six months.The alleviation of algopareunia,dysmenorrhea and pelvic pain and the occurrence of adverse reactions during treatment were observed in the two groups.The levels of serum follicle stimulating hormone (FSH),luteinizing hormone (LH),estradiol (E2) and prolactin (PRL) were compared between the two groups before and after treatment.After treatment,the clinical effect was evaluated according to the improvement of symptoms and the ultrasonographic results.Results　During the treatment period,the incidence of adverse reactions in the observation group and the control group was 28.6% (10/35) and 34.3% (12/35),respectively.There was no significant difference in the incidence of adverse reactions between the two groups (χ2=0.265,P>0.05).The adverse reactions of patients in the two groups disappeared gradually after drug withdrawal without serious impact on the patients.After treatment,the alleviation rate of algopareunia,dysmenorrhea and pelvic pain in the observation group was 100.0% (4/4),96.2% (25/26) and 97.1% (33/34),respectively;and it was 66.7% (2/3),61.5% (16/26) and 56.3% (9/16),respectively in the control group.The alleviation rates of dysmenorrhea and pelvic pain in the observation group were significantly higher than those in the control group (χ2=9.339,13.482;P<0.05),but there was no significant difference in alleviation rate of algopareunia between the two groups (χ2=1.556,P>0.05).There was no significant difference in the levels of serum E2,FSH,PRL and LH between the two groups before treatment (P>0.05).The levels of serum E2,FSH,PRL and LH after treatment were lower than those before treatment in the two groups (P<0.05).The levels of serum E2,FSH,PRL and LH in the observation group were lower than those in the control group after treatment (P<0.05).The cure rate,effective rate,inefficiency,recurrence rate and total effective rate were 51.4% (18/35),37.1% (13/35),5.7% (2/35),5.7% (2/35) and 88.6% (31/35) respectively in the observation group;and they were 25.7% (9/35),48.6% (17/35),11.4% (4/35),14.3% (5/35) and 74.3% (26/35) respectively in the control group.The cure rate in the observation group was higher than that in the control group (χ2=4.883,P<0.05),but there was no significant difference in the effective rate,inefficiency,recurrence rate and total effective rate between the two groups (χ2=0.933,0.729,1.428,2.362;P>0.05).Conclusion　GnRH-α treatment after laparoscopic surgery for ovarian endometriosis can improve pain and reproductive hormone levels,reduce recurrence rate,improve clinical efficacy,and has good safety.

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更新日期/Last Update: 2019-08-05