Objective To evaluate the efficacy of laparoscopic surgery and post-operation medicine for ovarian endometrioma.Methods All of 239 patients with ovarian endometrioma who were treated with ovarian cystectomy performed by laparoscopy were divided into three groups: untreated group,GnRH-a group,gestrinone group.The recurrence rate of the three groups and the side effects of the two kinds of medicine were compared.Results All the patients were followed up for 18 to 42 months,and the incidence of recurrence in the untreated group was higher than in GnRH-a group and gestrinone group(P 0.05),but there was no statistically significant difference between GnRH-a group and gestrinone group(P 0.05).The incidence of side effect in GnRH-a group was lower than gestrinone group.Conclusion Laparoscopic surgery is an effective way to treat ovarian endometrioma,and the use of GnRH-a or gestrinone after operation can reduce the incidence of recurrence,but the incidence of side effect in the gestrinone group is higher.
<正>宫腔粘连(intrauterine adhesions,IUA)又称Asherman综合征,多由对子宫基底膜的创伤及感染引起,主要症状为月经量异常(包括月经量减少和闭经等),周期性下腹痛,不孕及复发性流产等。近年来,随着人工流产率的增加及宫腔镜技术的不断发展,宫腔粘连的发病率及诊断率不断提高。宫腔镜被认为是诊断宫腔粘连的金标准,而应用宫腔镜治疗宫腔粘连是安全而有效的~[1]。轻度宫腔粘连治疗效果较好,但中、重度粘连术后易复发,预后较
Objective To investigate the clinical manifestation,diagnosis,treatment and the relationship between postoperative medical therapy and the recurrence of extrapelvic endometriosis.Methods The medical records of 67 patients with pathologically proven extrapelvic endometriosis from April 2003 to April 2010 in the Third Affiliated Hospital of Zhengzhou University were retrospectively reviewed,including 54 cases of abdominal wall endometriosis ( including I case of mesogastrium),6 cases of perineum endometriosis,7 cases of others(including 5 cases of posterior formix of vagina and 2 cases of vagina wall).Results Extrapelvic endometriosis can be diagposed through the typically clinical symptoms and accessory examination.The l -7 years ' follow-up investigation showed that the relapse rate was 12.3％,10.5％ for postoperative medication group and 13.2％ for non-medication respectively,there was no significant difference between the two groups (P ＞ 0.05).Conclusions Surgery is the most effctive way to cure extrapelvic endometriosis,medical therapy after surgery can not reduce the recurrence rate effectively.
Objective:To explore the effects of interleukin-18(IL-18),tumor necrosis factor-α(TNF-α) and vascular endothelial growth factor(VEGF) on the occurrence of intrauterine adhesion by detecting their expressions in endometrium of patients with intrauterine adhesion.Methods:The specimens of endometrium were collected from 60 patients with intrauterine adhesion diagnosed by hysteroscope(28 cases in severe intrauterine adhesion group and 32 cases in moderate intrauterine adhesion group) and 30 cases without intrauterine adhesion(control group),immunohistochemical staining was used to detect the expression levels of IL-18,TNF-α and VEGF in endometrium of the two groups.Results:The expression levels of IL-18,TNF-α and VEGF in endometrium of severe intrauterine adhesion group were significantly higher than those in control group and moderate intrauterine adhesion group(P<0.05);the expression levels of IL-18,TNF-α and VEGF in endometrium of moderate intrauterine adhesion group were significantly higher than those in control group(P<0.05).In severe intrauterine adhesion group and moderate intrauterine adhesion group,VEGF was positively correlated with IL-18 and TNF-α(P<0.05).In control group,there was no correlation between VEGF and IL-18,TNF-α(P>0.05).Conclusion:The high expressions of IL-18,TNF-α and VEGF may be related to the occurrence and development of intrauterine adhesion.
