目的:探讨中重度子宫内膜异位症患者腹腔镜保守手术术后联合促性腺激素释放激素激动剂(GnRH-α)治疗的效果及安全性。方法:选取2009年1月~2012年1月收治的腹腔镜保守性手术治疗的中重度子宫内膜异位症患者100例,随机分为两组,对照组50例不用药,观察组50例,使用GnRHa治疗。观察术中手术时间、术中出血、肛门排气、术后体温、术后疼痛、平均住院时间以及术后临床疗效、药物不良反应、停药后复发率及对卵巢、血清性激素水平[卵泡刺激素(FSH)、雌二醇(E2)、黄体生成素(LH)]的影响。结果:两组患者术后均恢复顺利,无术后并发症。两组手术后体温、平均住院的天数相差不大(P>0.05);观察组手术时间短,术中出血少,术后疼痛轻,肛门排气早,与对照组比较差异有统计学意义(P<0.05);对照组有4例未完全闭经,观察组无未完全闭经者;两组闭经时间及停药后月经复潮时间差异无显著性(P>0.05),观察组术后慢性盆腔痛、痛经、深部性交痛评分均明显低于对照组,且差异有统计学意义(P<0.05);两组临床症状,体征均得到明显改善,观察组未出现不良反应,总有效率两组比较差异有统计学意义(P<0.05);观察组优于对照组,观察组复发率为16.0%,对照组复发率为38.0%,两组比较差异有统计学意义(P<0.05);两组血清性激素水平和卵巢储备功能均得到明显效果,两组比较差异有统计学意义(P<0.05)。结论:腹腔镜保守手术后联合GnRH-αα治疗中重度子宫内膜异位症有效率高,复发率低,能提高术后妊娠率,且副反应小。 Objective: To investigate the efficacy and safety of combined GnRH-α after laparoscopic conservative surgery in patients with moderate-severe endometriosis. Methods: One hundred patients with moderate-severe endometriosis who underwent laparoscopic conservative surgery from January 2009 to January 2012 were randomly divided into two groups: control group (50 cases) and observation group (50 cases) , Using GnRHa treatment. The duration of operation, intraoperative bleeding, anal exhaust, postoperative body temperature, postoperative pain, average length of stay, and postoperative clinical efficacy, adverse drug reaction, relapse rate after drug withdrawal, and ovarian and serum hormone levels [follicular stimulation (FSH), estradiol (E2), luteinizing hormone (LH)]. Results: The two groups of patients recovered smoothly without postoperative complications. There was no significant difference between the two groups in the average body temperature after hospitalization (P> 0.05). The observation group had a shorter operative time, less intraoperative bleeding, less postoperative pain, and anus vent earlier than the control group (P> 0.05) P <0.05). In the control group, 4 cases had incomplete amenorrhea, and the observation group had no complete amenorrhea. There was no significant difference between the two groups in the amenorrhea time and menstrual period (P> 0.05) Pain, dysmenorrhea, deep pain scores were significantly lower than the control group, and the difference was statistically significant (P <0.05); clinical symptoms and signs were significantly improved in the observation group, no adverse reactions, the total effective rate of two groups The difference between the two groups was statistically significant (P <0.05). The observation group was superior to the control group. The recurrence rate was 16.0% in the observation group and 38.0% in the control group. There was significant difference between the two groups (P <0.05) Serum sex hormone levels and ovarian reserve were significantly improved, with significant difference between the two groups (P <0.05). Conclusion: Laparoscopic conservative surgery combined with GnRH-αα in the treatment of moderate-severe endometriosis has high efficiency and low recurrence rate, which can increase the rate of postoperative pregnancy with less side effects.