Clinical value of laparoscopic conservative operations combined with gonadotropin-releasing hormone analogue on treatment of moderate and severe ovarian endometriosis
10.3760/cma.j.issn.1673-4904.2014.21.009
- VernacularTitle:中重度卵巢型子宫内膜异位囊肿腹腔镜保守性手术后辅助促性腺激素释放激素类似物治疗的临床疗效分析
- Author:
Yefang XU
;
Lu HAN
;
Feng GUO
;
Xiaodong HU
- Publication Type:Journal Article
- Keywords:
Endometriosis;
Laparoscopes;
Gestrinone;
Gonadotropin-releasing hormone analogue
- From:
Chinese Journal of Postgraduates of Medicine
2014;37(21):26-29
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical value of gonadotropin-releasing hormone analogue (GnRH-a) by analyzing the efficiency of GnRH-a treatment for moderate and severe endometriosis after laparoscopic conservative operations.Methods Two hundred and sixty-five females who accepted laparoscopic conservative operation were enrolled in this study,and they were confirmed by pathology for ovarian endometriosis cyst,in phase Ⅲ andⅣ,47 patients had fertility desire.According to whether use the drug and auxiliary species the postoperative cases were divided into 5 groups:102 cases without endocrinal therapy(untreated group),GnRH-a group of 3 months in 64 cases,GnRH-a group of 6 months in 31 cases;gestrinone group of 3 months in 38 cases,and gestrinone group of 6 months in 30 cases.All patients were followed up for 2 years,observed drug clinical effects,remission rate,improvement rate,recurrence rate,pregnancy outcomes and side effects.Results The remission rate in GnRH-a group of 6 months and gestrinone group of 6 months was significantly higher than that in untreated group [83.9％ (26/31),73.3％ (22/30) vs.52.9％(54/102)],the remission rate in GnRH-a group of 6 months was significantly higher than that GnRH-a group of 3 months [64.1％ (41/64)],there was significant difference (P ＜ 0.05).The recurrence rate in GnRH-a group of 3 months,GnRH-a group of 6 months,gestrinone group of 6 months was significantly lower than that in untreated group [12.5％ (8/64),9.7％ (3/31),10.0％ (3/30) vs.27.5％ (28/102)] (P ＜ 0.05).The recurrence rate in gestrinone group of 6 months was significantly lower than that in gestrinone group of 3 months (P ＜ 0.05).The recurrence time of GnRH-a group of 3 months,GnRH-a group of 6 months,gestrinone group of 6 months was significantly longer than that in untreated group [(14.05 ± 1.97),(16.76 ± 1.53),(16.12 ±2.15)months vs.(12.85 ± 1.80)months] (P ＜0.05).The recurrence time of gestrinone group of 3 months and untreated group had no significant difference(P ＞ 0.05).The pregnancy rate of GnRH-a group and gestrinone group was higher than that in untreated group,but there was no significant difference (P ＞ 0.05).The rate of menopausal symptom in GnRH-a group was higher than that in gestrinone group [50.5％ (48/95) vs.16.2％ (11/68)].The rate of abnormal bleeding in vagina,acne and side-effect of aminotransferase in GnRH-a group were significantly lower than those in gestrinone group [1.1％(1/95) vs.7.4％(5/68),0 vs.8.8％(6/68),0 vs.5.9％(4/68)](P＜ 0.05).Conclusions Laparoscopic conservative operations combined with GnRH-a on treatment of moderate and severe ovarian endometriosis can significantly improve remission rate,decrease recurrence rate.GnRH-a or gestrinone for 6 months,the pregnancy rate increases.In addition the side reactions of the two medicine have statistic difference,which of GnRH-a is lower.
