目的:探讨促性腺激素释放激素激动剂(GnRHa)联合曼月乐治疗中重度子宫内膜异位症(EMs)保守性手术后的疗效。方法:选择腹腔镜保守性手术后中重度EMs、无生育要求的患者43例,随机分为2组,试验组23例,术后使用GnRHa联合曼月乐治疗,对照组20例,术后单纯使用GnRHa治疗。随访12个月,比较手术前、手术后3个月、6个月、9个月和12个月疼痛评分、CA125值和复发率。结果:试验组和对照组中,术后各时间点的疼痛评分均低于术前(P<0.05);试验组中术后各时间点的疼痛评分无统计学差异;对照组中术后12个月疼痛评分均高于术后3个月、6个月和9个月(P<0.05);在术后12个月试验组的疼痛评分低于对照组(P<0.05)。试验组和对照组中,术后各时间点CA125值均低于术前(P<0.05);试验组中术后各时间点CA125值无统计学差异。对照组中术后12个月CA125值均显著高于术后3个月、6个月和9个月(P<0.05)。术后12个月试验组的CA125低于对照组(P<0.05)。试验组的复发率为0.0%;对照组的复发率为15.0%。结论:GnRHa联合曼月乐治疗保守性手术后中、重度EMs,可以长时间缓解疼痛,降低术后复发率,是一种有效的巩固治疗方法。 Objective: To investigate the efficacy of GnRHa combined with Mirena in the treatment of moderate-severe endometriosis (EMs) after conservative surgery. Methods: Forty-three patients with moderate to severe laparoscopic surgery after moderate-to-moderate laparoscopic surgery were enrolled in this study. They were randomly divided into two groups: 23 cases in trial group, GnRHa combined with Mirena L after operation and 20 cases in control group Use GnRHa treatment. The patients were followed up for 12 months. The pain score, CA125 value and recurrence rate before surgery, 3 months after surgery, 6 months, 9 months and 12 months were compared. Results: The pain scores of the experimental group and the control group at all time points after operation were all lower than those before operation (P <0.05). There was no significant difference in pain scores between the two groups Month pain scores were higher than 3 months, 6 months and 9 months after operation (P <0.05). Pain score of the experimental group was lower than that of the control group at 12 months after operation (P <0.05). In the test group and the control group, the CA125 values ​​at all time points after operation were all lower than those before operation (P <0.05). There was no significant difference in CA125 between the two groups after operation. In the control group, the CA125 values ​​at 12 months after operation were significantly higher than those at 3 months, 6 months and 9 months after operation (P <0.05). The level of CA125 in the experimental group at 12 months after operation was lower than that in the control group (P <0.05). The recurrence rate was 0.0% in the experimental group and 15.0% in the control group. Conclusions: GnRHa and Mirena are effective consolidation therapy for moderate and severe EMs after conservative operation, which can relieve pain for a long time and reduce postoperative recurrence rate.