Clinical Observation Of Gestrinone And GnRH-a In The Treatment Of Postoperative Endometriosis

Objective:To compare the clinical effects of gestrinone and different courses of GnRH-a on patients with endometriosis after laparoscopic surgery,so as to provide data support and clinical guidance for the treatment of this disease.Methods:Picked 90 patients who were diagnosed as II-III endometriosis by laparoscopy in Affiliated Hospital of Qinghai University during the period from October 2016 to April 2017.Randomly divided then into 3 groups,gestrinone group,GnRH-a I group and GnRH-a II group,with 30 cases in each group.Patients in gestrinone group took gestrinone on the first days of menstruation after laparoscopy,2.5mg each time,2 times a week,first time of oral administration on first days of menstruation,taking it again 3 days later,then taking pills on the same time weekly,taking 6 months consecutively.Patients in GnRH-a I group were subcutaneously injected with gonadotropin releasing hormone agonist(GnRH-a)at the first days of menstruation after the operation,each time 3.75 mg,1 time every 28 days,lasting for 3 months.Patients in GnRH-a II group were subcutaneously injected with GnRH-a,each time 3.75 mg,1 time every 28 days,lasting for 6 months.Compared the changes of related symptoms(dysmenorrhea,algopareunia),sex hormones(estradiol,prolactin),tumor markers(CA125,CA19-9)and the pregnancy rate of each group in 6 months after stopping the treatment and resuming normal menstruation.Results: There were differences in the VAS scores of dysmenorrhea and algopareunia,the levels of basal estradiol,prolactin,CA125 and CA19-9 between 3 groups before and after treatment(P<0.05).There were differences in dysmenorrhea VAS score,basal estradiol and CA125 level after treatment between every 2 groups(P<0.05).After treatment,the prolactin level in the gestrinone group was statistically different from those in group GnRH-a I and GnRH-a II(P<0.05),but there was no significant difference between GnRH-a I group and GnRH-a II group(P>0.05).There was no statistical difference in the algopareunia VAS scores and the level of CA19-9 between 3 groups after treatment(P>0.05).In the 6 months after menarche withdrawal,the pregnancy rate of gestrinone group was 21.05%,the pregnancy rate of group GnRH-a I was 33.33%,the pregnancy rate of group GnRH-a and II was 31.58%,and there was no significant difference between 3 groups(P>0.05).Conclusions:For endometriosis patients after laparoscopic surgery,gestrinone and GnRH-a can relieve symptoms,improve endocrine,reduce the level of tumor markers and improve the pregnancy rate.And in dysmenorrhea remission,estradiol regulation and the decrease of CA125,GnRH-a is superior to gestrinone,and the longer the treatment is,the more obvious the effect is.