目的 探讨促性腺激素释放激素激动剂联合炔雌醇环丙孕酮片治疗重症子宫内膜异位症术后的临床疗效. 方法 将64例子宫内膜异位症患者按随机数字表法分为两组,观察组33例,对照组31例.两组患者均行腹腔镜手术治疗,术后予以醋酸戈舍瑞林缓释植入剂治疗,观察组在此基础上联合炔雌醇环丙孕酮片治疗,治疗6个月,随访1 a.比较两组患者的内分泌激素水平、临床症状严重程度及不良反应发生率.结果 随访1 a,两组患者卵泡刺激素、黄体生成素、雌二醇水平均较术前显著降低(P<0.05),同期两组间比较差异无统计学意义(P>0.05).两组临床症状总分及各项症状评分均较术前显著降低(P<0.05),观察组总分显著低于对照组(P<0.05).观察组不良反应发生率为9.1%,对照组为29.0%,观察组显著低于对照组(P<0.05).结论 促性腺激素释放激素激动剂联合炔雌醇环丙孕酮片治疗重症子宫内膜异位症可显著降低术后雌激素水平,改善临床症状,安全性高,值得临床应用.%Objective To explore the efficacy of GnRH-a combined with Diane-35 in the treatment of severe endometriosis.Methods Sixty-four endometriosis patients were randomly divided into observation (n=33) and control group (n=31).Both groups received laparoscopic operation and were treated with GnRH-a after operation, on this basis observation group was plus Diane-35 for 6 months, and followed up for 1 year.Endocrine hormone levels, severities of clinical symptoms and incidences of adverse reactions were compared between 2 groups.Results After 1 year follow-up follicle stimulating hormone, luteinizing hormone and estradiol levels of both groups lowered more significantly compared with pre-operation (P<0.05) and group differences in those had no statistical significance in the corresponding time period (P>0.05).Total and all symptoms scores of Kupperman Index of both groups lowered more significantly (P<0.05) and the total score was significantly lower in observation than in control group (P<0.05).The incidence of adverse reactions was significantly lower in observation than in control group (9.1% vs.29.0%, P<0.05).Conclusion GnRH-a combined with Diane-35 could notably lower postoperative estrogen level, improve clinical symptoms, has higher safety, and deserves clinical application.
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