摘要
目的：探讨卵巢子宫内膜异位囊肿合并不孕的患者术后治疗策略。方法：将腹腔镜下卵巢子宫内膜异位囊肿剥除术后要求妊娠的62例不孕患者随机分为期待组（n=31）和GnRH-a组（，n=31）。期待组腹腔镜手术后随访观察，避免使用激素类药物；GnRH-a组腹腔镜手术后月经第1日给予GnRH-a治疗：达菲林3．75mg皮下注射，1次／28d，连用3次停药。所有患者随访24个月。观察24个月内妊娠情况。结果：期待组12个月内妊娠率为41．9％（13／31），13-24个月内妊娠率为22．2％（4／31），24个月累积妊娠率为54．8％（17／31）。GnRH—a组1年内妊娠率为48．4％（15／31），13-24个月内妊娠率为18．8％（3／31），24个月累积妊娠率为58．1％（18／31）。期待组与GnRH—a组比较，12个月内妊娠率、24个月累积妊娠率组间均无统计学差异（P〉0．05）。结论：初步临床观察，卵巢子宫内膜异位囊肿剥除术后使用GnRH—a在提高EMs合并不孕患者妊娠率方面未显示出优势。
Objective： To explore the strategy for the treatment of endometriosis （EMs） complicated withinfertility patients. Methods： A total of 62 cases were randomly divided into expect group （n=31） and GnRH- a group （n=31）. The patients in expect group were followed up after operation without hormonal drugs. Thepatients at day 1 of menstruation after operation in GnRH-a group received diphereline 3.75 mg subcutaneous injection, once every 28 d for 3 times. All patients were followed up for 2 years, the pregnancy outcomeswere observed during this period. Results： In 12 months, 13 cases were pregnant in expect group, the pregnancy rate was 41.9%, 4 cases were pregnant during 13-24 months, the pregnancy rate was 22.2%, 24-month cumulativepregnancy rate was 54.8%. In 12 months, 15 cases were pregnant in GnRH-a group, the pregnancy rate was 48.4%, 3 cases were pregnant during 13-24 months, the pregnancy rate was 18.8%, 24-month cumulative pregnancy rate was58.1%. There was no significant difference of the pregnancy rate within 12 months and 24-month cumulative pregnancy rate between expect group and GnRH-a group （P〉0.05）. Conclusion： According to the preliminary clinicalobservation, postoperative use of GnRH-a showed no advantage in pregnancy rate of EMs with infertility patients.
出处
《生殖与避孕》
CAS
CSCD
2014年第6期515-518,共4页
Reproduction and Contraception
