文章摘要
陶莹1 牛刚2△ 骆婕1 杨文生1 何力1.腹腔镜术后联合GnRH-a治疗卵巢型内异症并不孕的疗效观察[J].,2014,14(15):2909-2913
腹腔镜术后联合GnRH-a治疗卵巢型内异症并不孕的疗效观察
Efficacy observation of Gonadotropin-releasing hormone agonist treatmentafter Laparoscopic Surgery in Ovarian Endometriosis-associated InfertilityPatients
  
DOI:
中文关键词: GnRH-a  卵巢型子宫内膜异位症  不孕
英文关键词: Gonadotropin-releasing hormone agonist  Ovarian endometriosis  Infertility
基金项目:
作者单位
陶莹1 牛刚2△ 骆婕1 杨文生1 何力1 1 广东药学院附属第一医院妇产科广东广州5100802 中山大学第一附属医院妇产科广东广州510080 
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中文摘要:
      摘要目的:研究腹腔镜保守术后联合短期促性腺激素释放激素激动剂( GnRH-a)对卵巢型子宫内膜异位症合并不孕患者的治疗 效果。方法:回顾性分析2008 年5月-2011 年5 月在我院治疗内异症合并不孕的126例患者的临床资料,比较腹腔镜手术后联合 GnRH-a治疗(用药组)和术后期待处理(对照组)的症状缓解率和妊娠情况。结果:用药组患者症状缓解率比对照组高,且差异有 统计学意义(P<0.05);用药组总妊娠率较对照组高,差异无统计学意义(P>0.05) ,流产率比较无统计学差异(P>0.05);治疗后患者 1 年内妊娠率最高,两组比较无统计学差异(P>0.05),随访期间累积妊娠率比较,用药组高于对照组,无统计学意义(P>0.05);用 药组及对照组中Ⅰ-Ⅱ期及Ⅲ-Ⅳ期患者妊娠率均在50%以上,两组比较均无统计学差异(P>0.05)。结论:此研究进一步明确腹腔 镜术联合GnRH-a治疗卵巢子宫内膜异位症合并不孕患者能较好提高其症状缓解率和妊娠率,但妊娠率提高与期待治疗无差别。 经手术或联合GnRH-a治疗后患者首次妊娠多发生在治疗后1 年内,如果1 年以上仍未妊娠,可根据实际情况选择其他助孕方法 如辅助生育技术,以增加受孕机会。
英文摘要:
      ABSTRACT Objective: To study the efficacy of short-term gonadotropin-releasing hormone agonist (GnRH-a ) treatment after laparoscopic conservative surgery in Ovarian Endometriosis-associated infertility patients. Methods:The clinical data of 126 infertile patients with ovarian endometriosis who received surgical therapy in the hospital fromMay 2008 to May 2011 were analyzed retrospectively, treatment group were treated with intravenous injection ofGnRH-a for three courses after surgery, control group were encouraged to get pregnancy, the symptom relief rate and conception conditions in these two groups were observed. Results:The symptom relief rate in treatment group was higher than in control group, and the difference was statistically significant (P<0.05); Total pregnancy rate in treatment group was higher than in control group, but there was no significant difference (P>0.05); There was no significant difference (P>0. 05) in abortion rate between two groups; The pregnancy rate was highest in the first year treatment in two groups with no statistically significant difference (P>0.05); Compared with control group, the cumulative pregnancy rate of treatment group was higher during follow- up (P>0.05); Pregnancy rate in stage Ⅰ-Ⅱ and Ⅲ-Ⅳ patients of two groups were more than 50%(P>0.05). Conclusion:This study further clarify laparoscopic surgery combined with GnRH-a treatment to ovarian endometriosis infertility patients can better improve their symptoms and pregnancy rates, but no difference in pregnancy rates with expectant treatment. Most of the pregnancy occurred in the first year after surgery or combined with GnRH-a therapy, considering the actual situation, other assisted reproductive methods such as assisted reproductive technology should be early encouraged for those patients remaining infertile for over one year after treatment, to increase the chances of conceiving.
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