促性腺激素释放激素激动剂用于子宫内膜异位症相关不孕症术后的效果  

Effect of Gonadotropin Releasing Hormone Agonist onEndometriosis Related Infertility

作　　者：陈慧然[1] 杨际新[1] 黄晗[1] CHEN Huiran;YANG Jixin;HUANG Han(Department of Gynecology and Obstetrics,Anshan Central Hospital,Anshan114000,China)

机构地区：[1]辽宁省鞍山市中心医院妇产科,鞍山114000

出　　处：《宁夏医科大学学报》2020年第12期1258-1262,共5页Journal of Ningxia Medical University

摘　　要：目的探究促性腺激素释放激素激动剂(GnRH-a)对育龄期卵巢子宫内膜异位症(ovarian endometriosis,OEM)相关不孕症患者腹腔镜术后的应用效果。方法回顾性分析2016年12月至2017年12月治疗的89例OEM相关不孕症患者的临床资料,按其治疗方法分为两组,对照组(40例)患者腹腔镜手术后不进行用药治疗,观察组(49例)患者腹腔镜术后采用GnRH-a治疗(1个月/次,连续3次);比较治疗3个月后两组患者的临床疗效,治疗前后血清糖类抗原125(CA125)、糖类抗原199(CA19-9)、胎盘蛋白14(PP14)、卵巢癌生物标记物4(HE4)、卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)水平,并比较术后2年内OEM相关子宫内膜异位症患者妊娠和复发情况。结果观察组总有效率为93.88%,高于对照组的72.50%(P<0.05)。两组患者治疗后CA125、CA19-9、PP14、HE4、FSH、LH、E2水平均低于治疗前(P均<0.05);治疗后组间比较,观察组患者CA125、CA19-9、PP14、HE4、FSH、LH、E2水平均低于对照组(P均<0.05)。观察组(20.41%)和对照组(15.00%)总不良反应率比较差异无统计学意义(P>0.05)。观察组患者妊娠率(67.35%)高于对照组(45.00%),复发率(8.16%)低于对照组(25.00%)(P均<0.05)。结论腹腔镜术后应用GnRH-a对育龄期OME相关不孕症患者的临床效果较好,可降低不孕症相关因子水平,提高术后妊娠率,降低复发率,且安全性高,值得临床推广。Objective To investigate the effect of gonadotropin releasing hormone agonist(GnRH-a)on ovarian endometriosis(OEM)related infertility patients after laparoscopic surgery.Methods The clinical data of 89 patients with OEM related infertility who were treated in our hospital from December 2016 to December 2017 were analyzed retrospectively.According to the treatment methods,they were divided into two groups:the control group(40 patients)was not treated with drugs after laparoscopic surgery,the observation group(49 patients)was treated with GnRH-a after laparoscopic surgery(1 month/time,three times in a row).The two groups were compared after three months of treatment.The levels of serum CA125,CA19-9,PP14,HE4,FSH,LH and E2 before and after treatment were compared.The pregnancy and recurrence of OEM related endometriosis patients within two years after operation were compared.Results The total effective rate in the observation group was 93.88%,which was significantly higher than that in the control group(72.50%)(P<0.05).The level of CA125,CA19-9,PP14,HE4,FSH,LH,E2 in the two groups after treatment was significantly lower than that before treatment(P all<0.05),and the level of CA125,CA19-9,PP14,HE4,FSH,LH,E2 in the observation group was significantly lower than that in the control group after treatment(P all<0.05).There was no significant difference in the total adverse reaction rates between the observation group(20.41%)and the control group(15.00%)(P>0.05).The pregnancy rate in the observation group(67.35%)was significantly higher than that in the control group(45.00%).The recurrence rate in the control group(8.15%)was significantly lower than that in the control group(25.00%)(P all<0.05).Conclusion The clinical effect of GnRH-a after laparoscopic surgery on infertile patients with ovarian endometriosis of childbearing age is good,which can reduce the level of infertile related factors,improve the postoperative pregnancy rate and reduce the recurrence rate,and high security,which is worthy of clinical promotion.

关 键 词：促性腺激素释放激素激动剂 卵巢子宫内膜异位症 不孕症 临床效果 

分 类 号：R711.71[医药卫生—妇产科学]