Analysis Of Clinical Effect Of Combination Of Dienogest And GnRH-a After Operation Of Ovarian Endometriosis Cyst

Objective:For patients undergoing laparoscopic removal of ovarian endometriosis cyst,and then supplemented with Dienogest and GnRH-a（gonadotropin releasing hormone agonist）.By observing the relevant effects in various aspects,the results with practical clinical significance were obtained,which provided a useful reference for our clinical treatment of ovarian endometriosis cyst.Methods:A total of 50 patients who underwent laparoscopic removal of ovarian endometriosis cyst in the gynecology department of Ma’anshan People’s Hospital from January 2021 to December 2021 were selected.They were randomly divided into Dienogest group and gonadotropinreleasing hormone agonist（GnRH-a）group（25 cases each）,among them,the GnRH-a group is the control group,and were treated with Dienogest and GnRH-a for 24 weeks after surgery,respectively.Using statistical methods to compare and analyze the ovarian reserve function（AMH,AFC）,pain index score（VAS）,carbohydrate antigen CA125,adverse reactions,recurrence,and pregnancy rates of two groups of patients before and after surgery.If P<0.05,the difference is statistically significant.Results:1.There is no significant difference between the two groups in age,preoperativeovarian function（AMH,AFC）,paindegree（VAS score）,carbohydrate antigen CA125,and intraoperative conditions（operation time,bleeding volume,and r-ASRM score）;2.Half a year after surgery,the ovarian reserve function（AMH and AFC）of the two groups were decreased to varying degrees compared with the preoperative level,and the decline was more obvious in the GnRH-a group.After comparison with the t test,there was a statistically significant difference in AMH between the two groups of patients（P<0.05）,while there was no statistically significant difference in AFC between the two groups;3.Half a year after surgery,the pain score（VAS）and CA125 of the two groups of patients decreased compared to before surgery,with a greater decrease in the Dienogest group.After t test,there was no statistical difference in VAS,while the difference in CA125 was statistically significant（P<0.05）;4.There were 6 cases（24%）of adverse reactions during the drug treatment in the Dienogest group;13 cases（52%）of adverse reactions occurred in GnRH-a group;During the treatment period,4 patients（16%）in the Dienogest group had amenorrhea,while 23 patients（92%）in the GnRH-a group.Comparison of adverse reactions and amenorrhea rate between the two groups.After thec^（17）test,the differencewas statistically significant（P<0.05）;5.Within 1 year after operation,only 1 case（4%）of patients in the Dienogest group had a relapse,and 3 cases（12%）had normal pregnancy;In GnRH-a group,there were 6 cases（24%）with recurrence and 2 cases（8%）with normal pregnancy.Compared with the recurrence rate of the two groups,afterc^（17）test,the P<0.05,which was statistically significant,but the difference inpregnancy rate was not statisticallysignificant.Conclusion:In preoperative and intraoperative conditions between the two groups,there was no significant difference;In terms of reducing pain and promoting pregnancy r ate after surgery,there is no significant difference in the efficacy of using Dienogest or GnRH-a,Dienogest is not inferior to GnRH-a in protecting ovarian reserve fun ction,inhibiting lesion growth,and preventing recurrence,and has lower adverse reac tions and amenorrhea rates.