宫腔内灌注抗结核药物治疗欲行试管婴儿助孕的子宫内膜结核患者的疗效及妊娠结局探讨  

Observation of the Efficacy and Pregnancy Outcome of Intrauterine Perfu-sion of Antituberculosis Drugs for Endometrial Tuberculosis Patients with the Desire for Pregnancy by the Treatment of IVF-ET

作　　者：孙鹏达[1] 孙淑杰[2] 刘佳梅[1] 

机构地区：[1]吉林大学白求恩医学院解剖与组胚系,吉林长春130021 [2]沈阳市和平区妇婴医院,辽宁沈阳110000

出　　处：《中外医疗》2016年第7期32-34,共3页China & Foreign Medical Treatment

摘　　要：目的探讨宫腔内灌注抗结核药物治疗子宫内膜结核的临床疗效及妊娠结局。方法随机选取并回顾性分析2005年1月—2014年12月于该院生殖中心欲行试管婴儿助孕的不孕症患者29例,经诊断性刮宫术刮取子宫内膜经病理诊断为子宫内膜结核及子宫内膜肉芽肿性炎,自愿接受宫腔灌注抗结核药治疗后进行体外授精-胚胎移植术(试管婴儿)助孕。宫腔灌注治疗后复查子宫内膜病理,子宫内膜结核病灶消失为治疗有效。行体外授精-胚胎移植术后30 d超声检查提示宫腔内见到妊娠囊,胎芽及胎心搏动为临床妊娠。结果 27例治疗后内膜病理提示结核病灶消失,8例妊娠。1例妊娠45日因异位妊娠而行腹腔镜手术。结论宫腔内灌注抗结核药物能有效治疗子宫内膜结核,不良反应少,治疗后临床妊娠率明显升高。Objective To investigate the efficacy and pregnancy outcome on intrauterine perfusion of antituberculosis drugs for endometrial tuberculosis patients. Methods Of the infertility patients with the desire for pregnancy by the treatment of in vitro fertilization and embryo transfer（IVF-ET） in the Reproductive Center of our hospital from December 2014 to January2005, 29 cases pathologically diagnosed with endometrial tuberculosis and endometrial granulomatous inflammation by diagnostic curettage with scraped endometrium voluntarily accepted the treatment of IVF-ET for pregnancy after intrauterine perfusion of antituberculosis drugs. After intrauterine perfusion treatment, the endometrial pathology was reviewed. If the endometrial tuberculosis disappears, then the treatment is thought to be effective. It is considered to be clinical pregnancy when the gestation sac and embryo with fetal heart beat appear in the uterine cavity found by the ultrasonic examination 30 days after IVF-ET. Results The result of pathological examination of endometrium showed that tuberculose focus disappeared in 27 cases and 8 cases had pregnancy after treatment. 1 case with pregnancy for 45 days underwent laparoscopic operation due to ectopic pregnancy. Conclusion Intrauterine perfusion of antituberculosis drugs can effectively treat the endometrial tuberculosis with less side effects and significantly high clinical pregnancy rate.

关 键 词：子宫内膜结核 抗结核药 诊断性刮宫术 体外授精-胚胎移植 

分 类 号：R4[医药卫生—临床医学]