子宫内膜异位症不孕患者腹腔镜术后不同治疗方法妊娠率比较  

Clinical Treatment Outcome Comparison of Different Therapeutic Regime of Gravidrate in Infertile Patients With Endometriosis Treated by Laparoscopic Operation

作　　者：黄冬梅[1] 冯虹[1] 黄敏[1] 周一平[1] 陈雪梅[1] 

机构地区：[1]广州中医药大学附属南海妇产儿童医院妇产科,广东南海528200

出　　处：《职业卫生与病伤》2005年第2期100-102,共3页Occupational Health and Damage

摘　　要：目的比较分析子宫内膜异位症不孕患者腹腔镜术后不同治疗方法妊娠率,探讨不同分期、方法对妊娠率的影响。方法1999-11/2004-11在广州中医药大学附属南海妇产儿童医院住院的不孕妇女或疑为EM经腹腔镜检查证实为EM的患者276例,双侧完全性输卵管阻塞患者或男方精液异常者不包括在内。Ⅰ、Ⅱ期患者随机分为A(促排卵药物组)、B(期待治疗组)2组;Ⅲ、Ⅳ期患者随机分C(戈舍瑞林组)、D(内美通组)2组,将随访结果进行统计分析。结果A、B、C、D组总妊娠率分别为55·9%、44·1%、57·5%、55·6%。期待治疗组(B组)较其他3组妊娠率低(P<0·05)。术后1年内妊娠者112例,其中术后8个月内妊娠者77例;2年内妊娠者27例,其中Ⅲ、Ⅳ期患者7例;2年后妊娠仅6例,2年后Ⅲ、Ⅳ期患者无1例受孕。结论腹腔镜保守手术后根据分期适时应用促排卵药物、抗子宫内膜异位的激素药物积极治疗可提高妊娠率。术后最佳治疗期限为12个月。Objective To compare and analyze the different therapeutic regime of gravid rate in infertile patients with endometriosis treated by laparoscopic operation; To discuss the effect of the different stages and methods in gravid rate. Methods Among the 276 patients of infertility women or uncertain EM and then EM patients treated by celioscope are in our hospital(1999-11/2004-11), except patients of double-side perfectibility fallopian tube emphraxis or male patients of semen abnormalities. Patients in phaseⅠ、Ⅱ were divided into Group A (urging ovulation medicine Group) and Group B(Expecting treatment Group) stochastically; patients in phase Ⅲ、Ⅳ were divided into Group C (Goserlin Group) and Group D(Gestrione Group) stochastically,and statistic analyze the result. Results The chief gravid rate of Group A、B、C、D were 55.9%、44.1%、57.5%、55.6%. The gravid rate of Expecting treatment Group (Group B) was lower than other three groups(P<0.05).Among 112 gestation women after operation, gestation women after operation 8 months were 77 cases; Among 27 gestation women in 2 years, gestation women (phase Ⅲ、Ⅳ) were 7 cases; Among only 6 gestation women after 2 years, no gestation woman (phase Ⅲ、Ⅳ) become pregnant. Conclusions Using urging ovulation medicine and hormone medicine of contradicting endometriosis by stages to treat patients actively by laparoscopic operation, which can improve gravid rate. The optimal treatment period is 12 months.

关 键 词：子宫内膜异位症 治疗方法 不孕患者 术后 广州中医药大学 促排卵药物 率比 妊娠率 腹腔镜检查 输卵管阻塞 比较分析 不孕妇女 医院住院 戈舍瑞林 统计分析 随访结果 8个月内 保守手术 积极治疗 激素药物 治疗期限 治疗组 

分 类 号：R711.71[医药卫生—妇产科学] R473.71[医药卫生—临床医学]