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目的:探讨腹腔镜与促性腺激素释放激素激动剂(Gn RH-a)联合治疗子宫内膜异位症(EMS)伴不孕症的临床疗效。方法:选择2012年1月~2014年12月期间我院收治的108例EMS伴不孕症患者作为研究对象,随机分为研究组与对照组,每组各54例。对照组患者采用腹腔镜治疗,研究组在此基础上于术后应用达菲林治疗。两组均行宫腔镜检查,观察两组临床疗效,1年内的妊娠率、复发率及两组患者治疗前后血浆雌二醇(E2)及卵泡刺激素(FSH)水平变化。结果:研究组治疗总有效率为98.15%,显著高于对照组的85.19%(P<0.05);两组1年内复发率对比差异无统计学意义(P>0.05);研究组1年内妊娠率为55.56%,高于对照组的27.78%(P<0.05)。研究组治疗后E2、FSH显著低于对照组及治疗前(P<0.05)。结论:腹腔镜联合Gn RH-a治疗EMS伴不孕症应用效果显著,可以有效改善患者的临床症状,提高妊娠率。
Objective: To investigate the clinical efficacy of laparoscopy and gonadotropin-releasing hormone agonist (Gn RH-a) in the treatment of endometriosis (EMS) with infertility. Methods: A total of 108 EMS patients with infertility treated in our hospital from January 2012 to December 2014 were selected as study subjects and randomly divided into study group and control group, with 54 cases in each group. The patients in the control group were treated with laparoscopy. The study group was treated with dafenin on the basis of this study. Hysteroscopy was performed in both groups to observe the clinical curative effect, pregnancy rate and relapse rate within one year and the changes of plasma estradiol (E2) and follicle stimulating hormone (FSH) before and after treatment in both groups. Results: The total effective rate of the study group was 98.15%, significantly higher than that of the control group (85.19%, P <0.05). There was no significant difference in recurrence rate between the two groups within one year (P> 0.05) 55.56%, higher than the control group 27.78% (P <0.05). The levels of E2 and FSH in the study group were significantly lower than those in the control group and before treatment (P <0.05). Conclusion: Laparoscopy combined with Gn RH-a treatment EMS with infertility significant effect, can effectively improve the clinical symptoms of patients and improve pregnancy rate.