Clinical effect of laparoscopic surgery combined with gonadotropin-releasing hormone agonist in the treatment of endometriosis

Abstract

Objective To investigate the clinical efficacy of laparoscopic surgery combined with gonadotropin-releasing hormone agonist (GnRH-a) in the treatment of endometriosis (EMs). Methods 86 patients with EMs were selected as study subjects.The patients were divided into two groups by random number table.43 patients in the control group underwent laparoscopic surgery, while 43 patients in the observation grouop received GnRH-a treatment based on laparoscopic surgery, and the clinical effect was analyzed. Results The total effective rate was 93.02% in the observation group, which was significantly higher than 72.09% in the control group.The recurrence rate in the observation group was 11.63%, which was significantly lower than 32.56% in the control group, the difference was statistically significant (χ2=7.55, 8.41, all P<0.05). After treatment, the levels of FSH, LH, and E2 of the observation group were (1.71±0.64)U/L, (2.66±0.75)U/L, (96.72±14.51)pmol/L, respectively, which were significantly lower than before treatment (t=8.80, 7.80, 7.55, all P<0.05), and the differences were statistically significant compared with the control group (t=8.55, 7.48, 7.19, all P<0.05). The total pregnancy rate of the observation group was 70.59%, which was significantly higher than 38.71% of the control group, the difference was statistically significant (χ2=7.77, P<0.05). The pain relief rate, dysmenorrhea rate, remission rate of chronic pelvic pain in the observation group were 90.70%, 86.05%, 93.02%, which were significantly higher than those in the control group (χ2=6.55, 7.01, 7.88, all P<0.05). The incidence rate of adverse reactions in the observation group was 11.63%, which was significantly lower than 27.91% in the control group, the difference was statistically significant (χ2=7.06, P<0.05). The main adverse reactions were hot flashes sweating, vaginal dryness, insomnia, fatigue and other low estrogen symptoms, which could tolerate, after treatment to relieve or disappear, liver and kidney function tests had no abnormalities. Conclusion Laparoscopic surgery combined with GnRH-a in the treatment of endometriosis can improve the treatment effect, improve the symptoms and reproductive hormone levels, improve the postoperative pregnancy rate, reduce the recurrence rate, and with high safety, it is worthy of clinical promotion and application. Key words: Endometriosis; Laparoscopic surgery; Gonadotropin-releasing hormone agonists