目的:探讨腹腔镜下卵巢内膜样囊肿剥除术联合促性腺激素释放激素激动剂(GnRH-a)注射对患者激素分泌、妊娠、月经恢复及囊肿复发的影响。方法:回顾性分析2014年6月~2016年6月间收治的90例卵巢内膜样囊肿患者临床资料,根据治疗方案分为观察组(n = 42)和对照组(n = 48)。2组均应用腹腔镜下卵巢内膜样囊肿剥除术,观察组在此基础上增加GnRH-a注射。随访2年,比较2组疗效,记录2组囊肿复发率、术后月经情况及妊娠情况,评估术前、术后6月的血清激素水平[雌二醇(E2)、促卵泡激素(FSH)、促黄体生成素(LH)]。结果:① 随访2年后,观察组总有效率高于对照组(P < 0.05);② 术后3月、术后6月时,2组囊肿复发率对比,差异无统计学意义(P > 0.05);术后2年时,观察组囊肿复发率低于对照组(P < 0.05);③ 术后随访2年,观察组妊娠14例,对照组妊娠9例,观察组妊娠率高于对照组(P < 0.05);2组经期时间、月经周期时间对比,差异均无统计学意义(P > 0.05);④ 术后6月时,2组E2、FSH、LH水平均低于术前(P < 0.05),观察组降幅大于对照组(P < 0.05)。结论:腹腔镜下卵巢内膜样囊肿剥除术后应用GnRH-a能降低术后囊肿复发率,有利于术后妊娠。
Objective: To explore the effects of laparoscopic benign ovarian cyst enucleation combined with gonadotropin-releasing hormone agonist (GnRH-a) on hormone secretion, pregnancy, menstrual recovery and cyst recurrence in patients. Methods: Clinical data of 90 patients with endometrial cysts admitted from June 2014 to June 2016 were retrospectively analyzed. According to the treatment regimen, the patients were divided into observation group (n = 42) and control group (n = 48). Both groups were treated with laparoscopic endometrial cystectomy, and GnRH-a injection was compared. The two groups were followed-up for 2 years, the efficacy of the two groups was compared, the recurrence rate of cysts in the two groups, the postoperative menstruation and pregnancy were recorded, and the serum hormone levels [estradiol (E2), follicle stimulating hor-mone (FSH), luteinizing hormone (LH)] before and 6 months after the operation were evaluated. Results: 1) After 2 years of follow-up, the total effective rate in observation group was higher than that in control group (P < 0.05). 2) 3 months after surgery and 6 months after surgery, the recur-rence rates of the two groups were compared, and the difference was not statistically significant (P > 0.05). 2 years after surgery, the recurrence rate of cyst in the observation group was lower than that in the control group (P < 0.05). 3) During the 2-year postoperative follow-up, 14 cases were pregnant in the observation group and 9 cases were pregnant in the control group. The pregnancy rate in the observation group was higher than that in the control group (P < 0.05). There was no significant difference in the menstrual time and menstrual cycle time between the two groups (P > 0.05). 4) Six months after surgery, E2, FSH and LH levels in both groups were lower than before (P < 0.05), the observation group decreased than the control group (P < 0.05). Conclusions: