【摘要】 目的：探究腹腔镜术后加用地屈孕酮治疗卵巢型子宫内膜异位症(EMs)疗效及对血清人附睾分泌蛋白4(HE4)、抗缪勒氏管激素(AMH)表达的影响。方法：选取2019年1月1日—2021年6月30日在本院接受腹腔镜手术的卵巢型EMs患者90例，随机分为常规组(45例)及联合组(45例),两组均术后给予孕三烯酮治疗，联合组加用地屈孕酮治疗。比较两组血清HE4、AMH水平变化，疼痛情况[疼痛模拟视觉评分法(VAS)],症状改善情况，临床疗效及不良反应发生情况。结果：与治疗前比较，两组治疗后血清HE4、AMH水平、盆腔痛、性交痛及痛经VAS评分均明显降低，且联合组幅度大于常规组(P<0.05);术后3个月症状评分联合组低于常规组(P<0.05),术后6个月症状评分两组无差异(P>0.05);治疗总缓解率联合组(93.3%)高于常规组(73.3%)(P<0.05),痤疮、转氨酶升高、体重增加、阴道干燥等不良反应总发生率两组无差异(P>0.05)。结论：腹腔镜术后加用地屈孕酮治疗卵巢型EMs有效降低患者血清HE4、AMH水平，减轻疼痛，改善临床症状且安全有效。更多还原

【Abstract】 Objective: To explore the efficacy of dydrogesterone in the treatment of ovarian endometriosis(EMs) after laparoscopic surgery, and to study its influence on the expression of serum human epididymis secretory protein 4(HE4) and anti-mullerian hormone(AMH). Methods: 90 patients with ovarian EMs who wanted laparoscopic surgery were gathered and randomly separated into two groups(45 cases in each group) from January 1, 2019 to June 30, 2021. The patients in the study group were treated with gestrinone combined with dydrogesterone, and the patients in the control group were treated with gestrinone. The change of the serum HE4 and AMH levels, the pain situation, such as pain visual analog scoring(VAS), the symptom improvement situation, the clinical efficacy, and the adverse reactions of the patients were compared between the two groups. Results: After treatment, the serum HE4 and AMH levels, the degree of pelvic pain, the pain rate during intercourse, and the VAS scores of the patients in the two groups had decreased significantly, and the ranges of which of the patients in the study group were significantly more than those of the patients in the control group(P<0.05). The symptom score of the patients in the study group in 3 months after surgery was significantly lower than that of the patients in the control group(P<0.05), and there was no significant difference in the symptom score of the patients in 6 months after surgery between the two groups(P>0.05). The total remission rate of the patients in the study group(93.3%) was significantly higher than that(73.3%) of the patients in the control group(P<0.05), and there were no significant differences in the incidences of acne, transaminase elevation, weight gain, vaginal dryness, and other adverse reactions of the patients between the two groups(P>0.05). Conclusion: Dydrogesterone in adjuvant therapy of ovarian endometriosis of the patients after laparoscopic surgery can effectively reduce their serum HE4 and AMH levels, relieve their pain, improve their clinical symptoms, which is safe and effective.更多还原