腹腔镜保留生育功能性手术治疗育龄期子宫内膜异位症性不孕临床观察  

Clinical observation on the operation of reserving fertility function with laparoscope in treating infertility of endometriosis in child-bearing period

作　　者：比丽克孜·艾克木[1] 岳明明[1,2] 刘娜[1] BILIKIZ Ekmu;YUE Ming-ming;LIU Na(Department of Gynecology,Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]新疆医科大学附属中医医院妇科,新疆乌鲁木齐830000 [2]新疆医科大学中医学院,新疆乌鲁木齐830011

出　　处：《中国医学装备》2019年第9期94-97,共4页China Medical Equipment

基　　金：新疆维吾尔自治区自然科学基金(2016D01C153)“汉族与维吾尔族子宫内膜息肉中医证型与雌激素受体、孕激素受体的相关性研究”

摘　　要：目的:探讨影响腹腔镜保留生育功能性手术治疗育龄期子宫内膜异位症性不孕妊娠的相关因素。方法:回顾性分析96例行腹腔镜保留生育功能性手术治疗的育龄期子宫内膜异位症性不孕患者资料,将术后成功受孕者纳入对照组(50例),未成功受孕者纳入观察组(46例)。对比两组患者年龄、不孕年限、术前激素水平中促卵泡成熟激素(FSH)、促黄体生成素(LH)、雌二醇(E2)、止血方式、病变范围、手术分期、术后复发及术后接受联合用药治疗情况。结果:观察组患者平均年龄高于对照组,差异有统计学意义(t=13.688,P<0.05);观察组中不孕年限长者比例高于对照组,差异有统计学意义(x^2=8.548,P<0.05)。术前两组FSH和LH水平比较,无统计学差异;观察组E2水平明显高于对照组,差异有统计学意义(t=30.381,P<0.05)。观察组患者电凝止血比例、双侧病变比例、Ⅲ~Ⅳ期比例以及复发比例均高于对照组,联合药物治疗比例明显低于对照组,差异有统计学意义(x^2=10.685,x^2=13.490,x^2=21.920,x^2=7.084,x^2=8.318;P<0.05)。结论:腹腔镜保留生育功能性手术治疗育龄期子宫内膜异位症性不孕时,患者年龄偏大、不孕年限长、高E2水平及电凝止血法等均为降低妊娠率的影响因素,Ⅲ~Ⅳ期患者妊娠率较低,术后采用药物联合治疗可提高妊娠率。Objective:To investigate the relevant factors that affected the operation of reserving fertility function with laparoscope in treating infertility of endometriosis in child-bearing period.Methods:The data of 96 patients with infertility of endometriosis in child-bearing period who underwent the operative treatment of reserving fertility function with laparoscope were retrospectively analyzed.The patients with postoperative successful conception were included in control group(50 cases),and the patients with postoperative unsuccessful conception were included in observation group(46 cases).The age,duration of infertility,age,preoperative hormone level[follicle stimulating hormone(FSH),luteotropic hormone(LH),estradiol(E2)],hemostasis methods,extent of lesion,surgical staging,postoperative recurrence and postoperative drug combination between two groups were further compared.Results:The average age of observation group was significantly higher than that of control group(t=13.688,P<0.05).The ratio of long duration of infertility in observation group was significantly higher than that in control group(x^2=8.548,P<0.05).Before surgery,there was no statistical difference in FSH level and LH level between the two groups.The E2 level in observation group was significantly higher than that in control group(t=30.381,P<0.05).The ratio of electric coagulation hemostasis,the ratio of bilateral lesions,the ratio ofⅢ-Ⅳstage,and the ratio of recurrence in observation group was significantly higher than that in control group,respectively,and the ratio of drug combination in observation group was significantly lower than that in control group(x^2=10.685,x^2=13.490,x^2=21.920,x^2=7.084,x^2=8.318,P<0.05).Conclusion:The operation of reserving fertility function with laparoscope in treating infertility of endometriosis in child-bearing period is affected by many influencing factors,including elderly age,long duration of infertility,high E2 level and electric coagulation hemostasis.The patients in theⅢ-Ⅳstage have lower pregnanc

关 键 词：子宫内膜异位症 不孕 腹腔镜保留生育功能性手术 育龄期 

分 类 号：R711.71[医药卫生—妇产科学]