| Objective: Endometriosis is endometrial tissue(glandular and mesenchymal)with a growth function outside the uterus and is seen clinically as an invasion of the pelvic organs and wall peritoneum.It is a benign gynecological disease that seriously affects the physical and mental health of women,mainly manifested by pain,infertility and adnexal cysts.Laparoscopic surgery is considered the gold standard for surgical treatment of Endometriosis because of its unique advantages in diagnosis and treatment.Medication can inhibit ovarian function and stop the development of endometriosis.It is scored and staged by The American Society for Reproductive Medicine,according to the extent of endometrial invasion of the peritoneum,ovaries,The Pouch of Douglas sites.The objective of this study was to analyze the clinical effect of Laparoscopic surgery combined with Leuprorelin in patients with stage Ⅲ Endometriosis.Methods: A total of 256 endometriosis patients treated at our hospital from July2019 to September 2020,of these,192 were treated with laparoscopic surgery;totally 22 patients who underwent laparoscopic surgery and completed 3 courses of leuprolide treatment were set up as a combined group.Collect the general information such as age,fertility status,history of previous pelvic surgery and other indicators in 192 patients;22 patients were selected as the surgical group from those who received only laparoscopic surgical treatment.Follow-up the treatment efficiency,pain level that Grading by the Visual Analogue Scale in both groups from six months to one year after treatment.Statistical software IBM Statistics SPSS 24.0 was used to process the data information for statistical analysis.Results: 1.The difference in general information between the two groups was not statistically significant.2.(1)The total treatment efficiency of the surgical group was 81.82% lower than that of the combined group,which was 90.91%,In the surgical group,2 cases still had dysmenorrhea after surgery,a total of 4 cases had dysmenorrhea 1 year after surgery,and a total of 2 cases had dysmenorrhea again 1 year after surgery in the combined group,the difference was statistically significant(P<0.05).(2)Both groups showed significant improvement in VAS scores after treatment compared to pre-treatment,and the improvement in VAS scores in the combined group was greater than that in the surgical group,the difference was statistically significant(P<0.05).(3)In the follow-up period from 6 months to 1 year after treatment,the recurrence rate was 4.54% lower in the combined group compared to 9.09%in the surgical group,the difference was statistically significant(P<0.05),two cases of surgery alone and one case of surgery combined with medication showed recurrence of ovarian endometriosis at 1 year follow-up,while the remaining patients showed no obvious signs of recurrence.Conclusions:Laparoscopic surgery can safely and effectively remove pelvic endometriosis lesions,however,it is difficult to completely remove microscopic lesions that are difficult to see with the naked eye,and there is a greater risk of recurrence after surgery.In conclusion,laparoscopic surgery combined with leuprolide was able to significantly increase the treatment rate,significantly improve pain symptoms,and reduce the recurrence rate of disease in patients with stage III ASRM endometriosis. |
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