目的 总结个体化腹腔镜手术与药物治疗子宫内膜异位症的疗效与经验。方法 回顾性分析2007年1月-2011年12月该院腹腔镜手术治疗子宫内膜异位症患者75例，根据不同临床表现、治疗愿望及镜下所见情况，采用不同的手术治疗及药物治疗方案。所有患者随访12个月，观察生殖激素水平、不良反应及疗效等情况。结果 随访12个月，失访2人，成功随访率为97.3%（73/75），完全缓解29例，缓解34例，无效10例；复发21例，受孕15例。治疗6个月后，患者FSH、LH、E2与PRL均下降，但只有FSH、LH与E2较术前明显下降，差异有显著性，P <0.05。反向添加42例，对盗汗、潮热及睡眠不良患者，反向添加效果较好；而对阴道干涩、突破出血及关节疼痛效果不明显。结论 腹腔镜手术后联合促性腺激素释放激素激动剂治疗子宫内膜异位症疗效较满意，值得临床推广应用。
【Objective】 To investigate the clinical efficacy of individualized laparoscopy combined with GnRH-a in treatment of patients with pelvic endometriosis. 【Methods】 75 patients with pelvic endometriosis treated in our hospital from January 2007 to December 2011 were recruited in this research. According to different clinical manifestations, goals of treatment and endoscopic findings, all the patients were treated with individualized schemes of operation and drug treatment. All the patients were followed up for 12 months. And the levels of reproductive hormones, adverse reaction and effect were recorded. 【Results】 Follow up of 12 months, lost 2 people, the follow-up rate is 97.3% (73/75). Complete remission was 29 cases, relieved 34 cases, invalid 10 cases, recurrence in 21 cases, 15 cases of pregnancy. FSH, LH, E2 and PRL decreased after 6 months of treatment, but only FSH, LH and E2 were significantly decreased, there was significant difference. Added back therapy in 42 cases, this treatment was good in patients with the sweating, hot flushes and sleep poor, while poor effect in the vaginal dryness, breakthrough bleeding and joint pain. 【Conclusion】 The effect of individualized laparoscopy combined with GnRH-a in treatment of patients with pelvic endometriosis is satisfactory. It is valuable to be recommended for clinical application.