Vercellini P, Vendola N, Bocciolone L, Colombo A, Rognoni M T, Bolis G
L. Mangiagalli Department of Obstetrics and Gynecology, University of Milan School of Medicine, Italy.
J Reprod Med. 1992 Jul;37(7):577-80.
In the period 1988-1990 this prospective study of 33 women with moderate or severe endometriosis who underwent laparoscopy for infertility and/or chronic pelvic pain, was conducted to evaluate the efficacy of aspirating endometriotic cysts followed by administration of a gonadotropin releasing hormone (GnRH) agonist in reducing the size of ovarian endometriomas. The cysts (mean diameter, 4.5 cm; range, 2-7; unilateral, 21 cases; bilateral, 12 cases) were punctured, aspirated, washed and emptied completely. After laparoscopy, 15 subjects received goserelin administered as a 28-day subcutaneous depot for three months, whereas 18 patients undergoing simple observation constituted internal controls. Ultrasound scans were performed before and at one, three and six months after laparoscopy. One case and three controls requested surgery between the four- and five-month follow-up scans and did not complete the study. All the other women had recurrent cysts at the six-month scan. There were no significant differences in mean endometrioma diameter between the two groups at any observation time nor between prelaparoscopic and six-month ultrasound examinations within each treatment group. We conclude that aspiration and washing of endometriotic cysts, combined with postoperative administration of GnRH agonists or not, is ineffective.
在1988年至1990年期间，对33例因不孕和/或慢性盆腔疼痛而接受腹腔镜检查的中度或重度子宫内膜异位症女性进行了这项前瞻性研究，以评估抽吸子宫内膜囊肿并随后给予促性腺激素释放激素（GnRH）激动剂在缩小卵巢子宫内膜瘤大小方面的疗效。囊肿（平均直径4.5厘米；范围2至7厘米；单侧21例；双侧12例）被穿刺、抽吸、冲洗并完全排空。腹腔镜检查后，15名受试者接受戈舍瑞林治疗，作为28天皮下植入剂，持续三个月，而18例接受简单观察的患者构成内部对照。在腹腔镜检查前以及检查后1个月、3个月和6个月进行超声扫描。1例患者和3例对照在4至5个月的随访扫描期间要求手术，未完成研究。所有其他女性在6个月扫描时均出现囊肿复发。在任何观察时间，两组之间的平均子宫内膜瘤直径均无显著差异，每个治疗组内腹腔镜检查前和6个月超声检查之间也无显著差异。我们得出结论，抽吸和冲洗子宫内膜囊肿，无论是否联合术后给予GnRH激动剂，均无效。
