唐习文　　何霞　　欧阳娟娟　　刘鸿

[關键词] 卵巢囊肿;促性腺激素释放激素激动剂;腹腔镜;性激素;妊娠

[中图分类号] R711.75          [文献标识码] B          [文章编号] 1673-9701（2021）15-0058-04

Impacts of laparoscopy combined with GnRH-a treatment on serum sex hormone level and pregnancy in patients with ovarian cyst

TANG Xiwen   HE Xia   OUYANG Juanjuan   LIU Hong

Department of Obstetrics and Gynecology， The Ninth Hospital of Nanchang， Jiangxi， Nanchang   330000， China

[Abstract] Objective To investigate the impacts of laparoscopy combined with gonadotropin releasing hormone agonist （GnRH-a） treatment on serum sex hormone level and pregnancy in patients with ovarian cyst. Methods A total of 86 patients with ovarian cyst admitted to our hospital from January 2017 to February 2019 were selected， and they were divided into the control group （n=43） and the observation group （n=43） according to the random number table method. The control group was treated with laparoscopic surgery， while the observation group was treated with GnRH-a combined with the basis of the control group. The clinical efficacy， serum sex hormone levels， postoperative pregnancy and relapse of cysts were compared between the two groups. Results The total efficacy rate in the observation group was 93.02%， higher than 76.74% in the control group， with statistically significant difference（P<0.05）. After operation， the levels of progesterone （P） and estradiol （E2） in the observation group were （3.21±0.48） poml/L and （66.84±14.79） poml/L， higher than （1.50±0.57） poml/L and （42.89±12.08） poml/L in the control group. The levels of luteinizing hormone （LH） and follicle stimulating hormone （FSH） were （12.49±2.36） IU/L and （18.32±3.68） IU/L， lower than （18.42±3.54） IU/L and （29.42±5.06） IU/L in the control group， with statistically significant difference（P<0.05）. After operation， the pregnancy rate in the observation group was 39.53%， higher than 11.63% in the control group， and the relapse rate was 4.65%， lower than 18.60% in the control group， with statistically significant differences（P<0.05）. Conclusion Laparoscopy combined with GnRH-a treatment can enhance the therapeutic efficacy， relieve clinical symptoms， improve sex hormone levels， reduce the relapse rate of cysts， and increase the pregnancy rate， which is worthy of clinical promotion.

[Key words] Ovarian cyst; Gonadotropin releasing hormone agonist; Laparoscopy; SEX hormone; Pregnancy

卵巢囊肿好发于育龄期女性的良性疾病，属于子宫内膜异位症，可导致患者出现慢性盆腔痛、月经不调、痛经等症状，随着病情发展可诱发内分泌失调、不孕不育、卵巢早衰或恶变等[1-2]。卵巢囊肿具有复发、增生、浸润、转移等恶性行为，需尽早治疗。腹腔镜手术具有微创、视野清晰、恢复快、美观性好、安全性高等优点，是临床治疗卵巢囊肿的首选[3]。但随着临床治疗发现，腹腔镜手术无法彻底将病灶清楚，易造成卵巢功能损伤，术后复发率高、妊娠率低[4]。卵巢囊肿属于雌激素依赖性疾病，腹腔镜手术辅以促性腺激素释放激素激动剂（Gonadotropin-releasing hormone agonist，GnRH-a）治疗能够改善机体性激素水平，增强治疗效果，改善患者卵巢功能，降低术后复发率，为妊娠提供良好条件[5]。本研究卵巢囊肿患者行GnRH-a辅助腹腔镜治疗效果，以指导临床制定合理治疗方案，现报道如下。

1 资料与方法

1.1 一般资料

选择江西省南昌市第九医院妇产科于2017年1月至2019年2月收治的卵巢囊肿患者86例。本研究经医学伦理委员会审核批准。按随机数字表法将患者分为观察组（n=43）和对照组（n=43）。观察组年龄20～37岁，平均（32.48±2.45）岁;肿瘤直径5～10 cm，平均肿瘤直径（6.68±1.02）cm;疾病类型：卵巢畸胎瘤、卵巢子宫内膜异位囊肿、卵巢冠囊肿各9例、26例、8例。对照组年龄21～36岁，平均年龄（32.37±2.38）岁;肿瘤直径5～10 cm，平均肿瘤直径（6.73±0.99）cm;疾病类型：卵巢畸胎瘤、卵巢子宫内膜异位囊肿、卵巢冠囊肿各10例、24例、9例。……