摘要
目的探讨术后辅助非周期应用促性腺激素释放激素激动剂(GnRH-α)对重度卵巢子宫内膜异位症患者卵巢储备功能及生育的影响。方法腹腔镜卵巢囊肿剔除术患者150例分为三组:A组50例,为卵巢成熟性囊性畸胎瘤;重度卵巢子宫内膜异位囊肿患者100例中,52例术后周期应用GnRH-α治疗(B组),48例术后非周期应用GnRH-α治疗(C组)。随访1年,比较性激素[卵泡刺激素(FSH),黄体生成素(LH),雌二醇(E_2)]水平、窦状卵泡数(AFC)、卵巢间质动脉血流的收缩期峰值(PSV)变化及妊娠结局。结果 A组手术前、术后的FSH、LH、E_2、AFC和PSV均无明显变化(P>0.05)。术后3个月,B、C组的上述指标均低于A组,C组高于B组(P<0.05);术后6个月,B组的上述指标低于A、C组(P<0.05),但A、C组比较无统计学差异(P>0.05)。A组妊娠率90.0%,高于B和C组的35.3%和53.3%(P<0.05),C组妊娠率稍高于B组(P>0.05)。结论对重度卵巢子宫内膜异位症患者,术后非周期应用GnRH-α较周期应用对卵巢功能影响小,可提高子宫内膜异位症不育患者的妊娠率。
Objective To explore the effects of treatment with aperiodically injecting GnRH-α on ovarian reserve function and pregnantic outcome in severe endometriosis after laparoseopic surgery. Methods Laparoscopic cystectomy was performed in 150 patients with ovarian cysts, who were divided into three groups of A （with ovarian mature cystic teratoma, 50 cases）, B （with severe endometriosis treated with periodically injection of GnRH-α after operation, 52 cases） and C（with severe endometriosis treated with aperiodically injection of GnRH-α after operation, 48 cases）. All patients were followed up for 12 months. The changes of sex hormones（FSH, LH and E2 ）, antral follicle count（AFC）, peak systolic ovarian stromal artery blood flow（PSV） and pregnantic outcome were compared. Results Compared to before,the levels of FSH,LH and E2 ,and AFC,PSV were not significantly changed after operation（P〉0. 05）. The levels of FSH, LH and Fe, and AFC, PSV in 3 months after operation were lower in groups of B and C than those in group A, which were higher in group C than those in group B（P〈0. 05）. The levels of FSH,LH and E2 ,and AFC,PSV in 6 months after operation were lower in group B than those in groups of A and C, which were not significantly different between groups of A and C（P〉0. 05）. The pregnancy rate of group A was 90.0%, which was higher than 35.3% of group B and 53.3% of group C（P〈0. 05）. The pregnancy rate of group C was slightly higher than that of group B（P〉0. 05）. Conclusion A treatment with aperiodically injection of CmRH-α after operation has less effect on ovarian functions than periodically injection of GnRH-α in severe endometriosis after laparoscopic surgery, which may be benefitial to the increase of pregnancy rate.
作者
乔海风
刘颖蕾
鲁晓燕
郁超
张忠新
刘曼华
QIAO Haifeng LIU Yinglei LU Xiaoyan et al(Department of Obstetrics and Gynecology, Second Affiliated Hospital, Nantong University, Nantong 226000, CHIN)
出处
《江苏医药》
CAS
2017年第7期470-472,共3页
Jiangsu Medical Journal
基金
南通市科技局科研项目(HS2014074)
南通市卫生局青年基金(WQ2014023)
