药物联合宫腹腔镜探查术对不孕症合并早中期内异症的疗效分析  

Investigation on the effect of drugs combined with uterine laparoscopic exploration on infertility combined with early and middle period endometriosis

作　　者：郭晨[1] 汪利群[1] GUO Chen;WANG Liqun(Jiangxi Maternal and Child Health Hospital,Nanchang,330006,China)

机构地区：[1]江西省妇幼保健院

出　　处：《江西医药》2020年第2期103-106,139,共5页Jiangxi Medical Journal

基　　金：江西省卫健委科技计划项目，编号：20195480

摘　　要：目的探讨不同药物联合宫腹腔镜联合探查手术治疗不孕症合并早中期(I、II期)子宫内膜异位症((endometriosis,EMs)的临床效果。方法回顾性分析120例2016年1月-2018年月1月在江西省妇幼保健院生殖健康科住院或日间门诊的不孕症患者,患者均行标准的宫腹腔镜联合探查术,术中被发现为I-II期子宫内膜异位症患者被纳入研究。根据术后用药不同将受试者随机分为两组,分别为研究组与对照组;研究组术后接受口服避孕药治疗连续使用屈螺酮炔雌醇(II)治疗;对照组为术后口服使用孕三烯酮组。术后随访1-1.5年,比较各组术后临床症状改善情况及妊娠结局。结果⑴两组术前术后CA125水平和VAS评分均较同组术前水平有显著下降(P<0.05),但术后两组间比较无显著性差异(P>0.05)。两组术后3个月血清FSH、E2及AMH水平均较同组术前无明显变化(P>0.05),两组间比较亦无显著性差异(P>0.05)。⑵纳入对象中120例EMs相关性不孕症患者均有生育意愿,术后随访共1.5年时间内的妊娠情况。结果显示:两组共有76例(63.33%)患者获得妊娠,其中研究组的总妊娠率略高于对照组组(72.27%vs 51.58%),且有统计学性差异(P<0.05)。⑶总共17例患者发生药物不良反应,其中研究组7.58%(5/66),对照组22.22%(12/54),组间发生率比较有统计学差异(P<0.05)。结论不孕症合并早中期EMs患者行宫腹腔镜保守性手术后联合药物治疗可改善临床治疗效果,改善自然妊娠率,且屈螺酮炔雌醇(II)可获得更良好的妊娠情况及更少的药物不良反应。Objective To explore the clinical effect of different drugs combined with laparoscopy on infertility combined with early and middle stage I and II endometriosis(EMs).Methods A retrospective analysis was performed on 120 patients with infertility who were admitted to the reproductive health department of JiangXi provincial maternal and child health hospital from January 2016 to January 2018.All patients received standard laparoscopy,and the patients who were found to have stage I-II endometriosis were included in the study.Subjects were randomly divided into two groups according to different postoperative medication,the study group and the control group,respectively.The study group received oral contraceptives after surgery and continued to receive Drospirenone and Ethinylestradiol Tablets(II).The control group was taken gestrinone after operation.Postoperative follow-up was conducted for 1-1.5 years to compare the improvement of postoperative clinical symptoms and pregnancy outcome in each group.Results(1)Both the preoperative and postoperative CA125 levels and VAS scores of the two groups were significantly lower than the preoperative levels of the same group(P<0.05),but there was no significant difference between the two groups(P>0.05).The serum levels of FSH,E2 and AMH in the two groups 3 months after the operation showed no significant changes(P>0.05)compared with the same group before the operation,and there was no significant difference between the two groups(P>0.05).(2)Among the included subjects,120 EMs-related infertility patients all had fertility intention,and pregnancy status was followed up for a total of 1.5 years.Results showed that a total of 76 patients(63.33%)were pregnant in the two groups,and the total pregnancy rate in the study group was slightly higher than that in the control group(72.27%vs 51.58%),with a statistically significant difference(P<0.05).(3)A total of 17 patients had adverse drug reactions,including 7.58%(5/66)in the study group and 22.22%(12/54)in the control group,with statis

关 键 词：屈螺酮炔雌醇(II) 不孕症 盆腔子宫内膜异位症 

分 类 号：R713[医药卫生—妇产科学]