中国内镜杂志2025，Vol.31Issue(10)：40-47,8.DOI:10.12235/E20250049
单孔腹腔镜联合促性腺激素释放激素激动剂治疗深部浸润型子宫内膜异位症的临床疗效及对预后的影响
Clinical efficacy of single-port laparoscopy combined with GnRH agonist in the treatment of deep infiltrating endometriosis and its influence on prognosis
摘要
Abstract
Objective To explore the clinical efficacy of single-port laparoscopy combined with gonado-tropin-releasing hormone agonist(GnRH agonist)in the treatment of deep infiltrating endometriosis and its influence on serum circATRNL1 levels,and analyze its predictive value for patient prognosis.Methods 220 patients with deep infiltrating endometriosis from June 2021 to October 2023 were enrolled as study subjects and divided into an experimental group(n=110)and a control group(n=110)according to different surgical methods.The experimental group received single-port laparoscopy surgery combined with GnRH agonist treatment,while the control group only received single-port laparoscopy surgery.The changes in circATRNL1 expression level before and after treatment between the two groups were compared,the short-term efficacy and long-term prognosis of the two groups were evaluated.Spearman correlation analysis was conducted to explore the relationship between circATRNL1 expression levels after treatment and long-term prognosis.All patients were regrouped based on whether they relapsed during follow-up into a relapse group(n=42)and a non-relapse group(n=178).The circATRNL1 levels before and after treatment were compared between the two groups,and the predictive value of circATRNL1 expression levels after treatment for long-term relapse after treatment in patients with endometriosis was analyzed using a receiver operating characteristic curve(ROC curve).Results After treatment,the serum circATRNL1 levels in the experimental group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).The postoperative pain VAS score of the experimental group was significantly lower than that of the control group,and the quality of life was significantly better than that of the control group,the recurrence rate was significantly lower than that of the control group,and the differences were statistically significant(P<0.05).The pregnancy rate of the experimental group was higher than that of the control group,and the postoperative dysmenorrhea rate was lower than that of the control group,but the differences were not statistically significant(P>0.05).Spearman correlation analysis showed that circATRNL1 expression levels after treatment was positively correlated with relapse among long-term prognosis indicators(r=0.290,P<0.05),but had no significant correlation with pregnancy rate(r=0.060,P>0.05).Compared to patients in the non-relapse group,the relapse group had significantly higher serum circATRNL1 expression levels after treatment,the difference was statistically significant(P<0.05).ROC curve analysis showed that the area under the curve(AUC)for serum circATRNL1 expression levels in predicting long-term postoperative relapse in patients with endometriosis after treatment was 0.746,with a sensitivity of 64.29%and a specificity of 82.02%,indicating good predictive value.Conclusion The treatment regimen combining single-port laparoscopy with GnRH agonist can significantly reduce patients'pain levels,improve their quality of life,and decrease the recurrence rate.Furthermore,this combined therapy also notably decreases serum circATRNL1 levels.The serum circATRNL1 expression levels have good predictive value for the long-term recurrence of deep-infiltrating endometriosis patients post-surgery.关键词
单孔腹腔镜/促性腺激素释放激素激动剂(GnRH agonist)/子宫内膜异位症/circATRNL1/预后分析/预测价值Key words
single-port laparoscopy/gonado-tropin-releasing hormone agonist(GnRH agonist)/endometriosis/circATRNL1/prognosis analysis/predictive value分类
临床医学引用本文复制引用
王晓倩,彭媛媛,张艺鸣,潘庆云,张晓倩,李燕,刘茜..单孔腹腔镜联合促性腺激素释放激素激动剂治疗深部浸润型子宫内膜异位症的临床疗效及对预后的影响[J].中国内镜杂志,2025,31(10):40-47,8.基金项目
衡水市科学技术局项目(No:2024014015Z) （No:2024014015Z）
