Heinrichs W L, Henzl M R
Department of Gynecology and Obstetrics, Stanford University School of Medicine, CA 94305, USA.
J Reprod Med. 1998 Mar;43(3 Suppl):299-308.
To project the efficacy and economic consequence of short-term intranasal gonadotropin-releasing hormone agonist (GnRH-a) for diagnosis of and therapy for endometriosis.
Multicenter, placebo-controlled clinical trials of GnRH-a comparing three vs. six months of treatment, three months of retreatment and three months of postoperative treatment for the symptoms and signs of laparoscopically diagnosed endometriosis.
The reduction in symptoms and signs of endometriosis was similar at the end of three months to the relief at six months. Retreatment was as effective as initial treatment, and the return of symptoms after laparoscopic surgery plus postoperative treatment for three months was delayed by approximately 18 months as compared to surgery alone. The projected charges for the surgical approaches (laparoscopy or minilaparoscopy) to diagnosis and therapy were 50-60% greater than those for the medical approach.
GnRH-a administration for three months could be a cost-effective approach to the presumptive diagnosis and treatment of endometriosis among women with chronic pelvic pain.
预测短期鼻内给予促性腺激素释放激素激动剂（GnRH-a）用于子宫内膜异位症诊断和治疗的疗效及经济后果。
GnRH-a的多中心、安慰剂对照临床试验，比较治疗三个月与六个月、再治疗三个月以及腹腔镜诊断的子宫内膜异位症症状和体征的术后三个月治疗情况。
三个月末子宫内膜异位症症状和体征的减轻程度与六个月时的缓解程度相似。再治疗与初始治疗效果相同，与单纯手术相比，腹腔镜手术加术后三个月治疗后症状复发延迟约18个月。诊断和治疗的手术方法（腹腔镜或微型腹腔镜）预计费用比药物治疗方法高50%-60%。
对于慢性盆腔疼痛的女性，给予GnRH-a三个月可能是一种具有成本效益的子宫内膜异位症推定诊断和治疗方法。
