摘要目的：观察卵巢子宫内膜异位症患者保守性手术后应用地屈孕酮与孕三烯酮的临床疗效及不孕患者的妊娠情况。方法随访分析南京军区福州总医院2009年1月至2013年8月收治的行保守性手术治疗的150例卵巢子宫内膜异位症患者，术后随机采用地屈孕酮者76例，孕三烯酮者54例；比较两组患者治疗后的疼痛症状改善情况、1年后复发率和妊娠率及不良反应情况。结果地屈孕酮组与孕三烯酮组用药后均有较高的疼痛缓解率，较低的复发率，两组比较差异无统计学意义（ P均﹥0.05）。不良反应：地屈孕酮组以乳房胀痛为主，发生率为3.9％（3/76）；孕三烯酮组无乳房胀痛，两组比较差异无统计学意义（P＝0.140）。孕三烯酮组以肝功能损害为主，发生率为25.9％（14/54）；地屈孕酮组未见肝功能损害，两组比较差异有统计学意义（ P＝0.000）。两组患者均出现阴道不规则出血，地屈孕酮组发生率为15.8％（12/76），孕三烯酮组为13.0％（7/54），两组比较差异有统计学意义（P＝0.038）。两组术后血清糖链抗原-125浓度均降至正常，3个月仍有下降，6个月后无明显变化。地屈孕酮组术后1年妊娠率（80％，24/30）明显高于孕三烯酮组（48％，12/25），两组比较差异有统计学意义（ P＝0.038）。结论卵巢子宫内膜异位症术后行地屈孕酮巩固治疗效果与孕三烯酮比较无明显差异，但地屈孕酮治疗无明显肝功能损害，服药期间有较高的妊娠率，可明显提高术后1年的累积妊娠率。

abstractsObjective To compare the clinical effects of dydrogesterone and gestrinone on postoperative endometriosis and the rate of pregnancy in patients with infertility. Methods One hundred and fifty patients with postoperative endometriosis were enrolled in the current study who were hospitalized in fuzhou General Hospital of Nanjing Command from Jan. 2009 to Aug. 2013. They were randomly divided into dydrogesternne group(76 cases)and gestrenone groups(54 cases)based on progestogent treatment. The situation of pain symptoms improvement,the recurrence rate of 1 year,side effects and postoperative pregnancy rate were observed in order to evaluate the drug efficacy. Results There were a high rate of postoperative pain remission rate and a low recurrence rate of the two groups,and the difference was not significant( P ﹥0. 05 ). The main adverse reaction of patients in dydrogesterone group was breast pain and the incidence rate was 3. 9%( 3/76 ),while there was no breast pain in gestrinone group,and the difference was not significant( P =0. 140 ). The main adverse reaction of patients in gestrinone group was liver function damage and the incidence rate was 25. 9%(7/54),while the dydrogesterone group hadn't liver function damage,and the difference between two groups was significant( P =0. 000 ). The abnormal uterus bleeding incidence rate in dydrogesterone group was 15. 8%(12/76),higher than that of gestrinone group(13. 0%(7/54)),and the difference was significant(P=0. 038) . The serum carbohydrate antigen-125(CA-125)level in two groups were down to normal after operation,and still declined after drug treatment for 3 months. But there was no obvious change after 6 months. One year pregnancy rate of dydrogesterone pregnancy was 80%(24/30),higher than that of gestrinone group(48%,12/25),and the difference was significant( P =0. 038 ). Conclusion There is no significant difference in therapeutic effect between two groups. However,dydrogesterone therapy have no significant liver damage,and a higher postoperation pregnancy rate.