长效糖皮质激素联合促性腺激素释放激动剂腹腔镜术腔冲洗在子宫内膜异位症治疗中的应用效果

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Abstract Objective To explore the application effect of long acting glucocorticoid combined with gonadotropin releasing agonist laparoscopic irrigation in endometriosis (EMS). Methods From January 2014 to December 2016, 69 patients with EMS treated by laparoscopic surgery in Central Hospital of China National Petroleum Company were selected as the study objects. Patients were divided into two groups according to washing methods. Thirty-four cases in the control group, and laparoscopic electrocoagulation and cauterization were used to wash pelvic cavity repeatedly with 1000 mL of 0.9% physiological saline during operation. Thirty-five cases in the experimental group were treated with the same method as the control group. Intraoperative irrigation was done with 0.9 % saline 500 mL + 20 mg Dexamethasone and 0.9% saline + Triptorelin 3.75 mg, first with saline Dexamethasone lavage fluid, and then with Triptorelin diluent lavage. The changes of dysmenorrhea, pelvic pain, sexual intercourse pain and inflammatory factor levels in the two groups before and after operation for 3, 6 and 12 months were observed. All patients were followed up for 1 year after operation, and the pregnancy, recurrence and adverse reactions were observed. Results One day and three day after operation, the serum levels of C reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor (TNF-α) in the two groups were lower than those before operation(P < 0.05). One day after operation, the levels of CRP, IL-6, and TNF-α in the experimental group were lower than those of the control group (P < 0.05); the visual analogue score (VAS) scores at 3 and 12 months post operatively in both groups were lower than those before operation; and the 3, 6 and 12 months postoperatively were lower than those before the same group (P < 0.05), 6 and 12 month postoperative the VAS scores of the study group were lower than those of the control group(P < 0.05). The rate of spontaneous pregnancy in the experimental group was 65.71%, higher than that in the control group (38.24%, P < 0.05), and the recurrence rate in the study group was 2.86%, lower than that in the control group (29.41%, P < 0.05). During the one year of follow-up period, there was no significant difference in the total incidence of adverse reactions between the two groups (P > 0.05). Conclusion Glucocorticoid combined with gonadotropin-releasing hormone agonist laparoscopic surgical cavity rinse in the treatment of EMS can reduce the levels of inflammatory factors and the degree of postoperative pain, improve the one year natural pregnancy rate, and it is worthy of clinical promotion.

Key words： Glucocorticoid Gonadotropin-releasing hormone agonist Laparoscope Cavity irrigation Endometriosis

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	MENG Xianning LI Hongxia HUO Zhiping WU Ya′nan WANG Hongli HAO Yuanyuan

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MENG Xianning LI Hongxia HUO Zhiping WU Ya′nan WANG Hongli HAO Yuanyuan. Effect of long acting glucocorticoid combined with gonadotropin-releasing agonist laparoscopic irrigation in the treatment of endometriosis[J]. 中国医药导报, 2018, 15(29): 74-78.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2018/V15/I29/74

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