探讨促性腺激素释放激素激动剂不同给药时机对巧克力囊肿剥除术患者自然妊娠率的影响  

Effect of gonadotropin-releasing hormone agonist administration at different times on the natural pregnancy rate of patients undergoing ovarian chocolate cyst exfoliation

作　　者：张琴[1] 张花梅[2] 张延志[1] Zhang Qin;Zhang Huamei;Zhang Yanzhi(Department of Gynecology,Binzhou Central Hospital,Binzhou 251700,China;Department of Obstetrics,Binzhou Central Hospital,Binzhou 251700,China)

机构地区：[1]滨州市中心医院妇科,山东滨州251700 [2]滨州市中心医院产科,山东滨州251700

出　　处：《中国临床实用医学》2021年第1期47-51,共5页China Clinical Practical Medicine

摘　　要：目的探究与分析促性腺激素释放激素激动剂(GnRH-a)不同给药时机对巧克力囊肿(OCC)剥除术患者自然妊娠率的影响。方法回顾性分析2018年5月至2019年5月滨州市中心医院妇科收治的110例女性OCC剥除术患者的临床资料,年龄(30.45±2.44)岁,年龄范围为25~34岁。按照GnRH-a不同给药时机分为术前给药组(n=61)与术后给药组(n=49)。术前给药组患者术前给予达菲林,术后给药组患者术后给予达菲林,比较两组患者围术期指标、临床治疗效果、治疗前后性激素[卵泡刺激素(FSH)、黄体生成素(LH)及雌二醇]水平及随访1年的自然妊娠率。结果术前给药组患者的手术时间[(76.24±14.08)min]、术后排气时间[(19.32±3.81)h]、术中出血量[(45.89±8.30)ml]及腹腔引流液量[(53.23±8.12)ml]均少于术后给药组[(104.97±19.36)min、(22.78±4.21)h、(60.52±12.44)ml、(60.85±11.34)ml],并发症发生率[1.6%(1/61)]低于术后给药组[14.3%(7/49)],差异有统计学意义(P<0.05)。术前给药组患者临床有效率[96.7%(59/61)]及随访1年自然妊娠率[73.8%(45/61)]均高于术后给药组[85.7%(42/49)、55.1%(27/49)],差异有统计学意义(P<0.05)。治疗后,术前给药组与术后给药组患者FSH[(3.28±1.41)IU/L、(5.09±1.53)IU/L]、LH[(1.20±0.52)IU/L、(1.40±0.37)IU/L]及雌二醇[(32.87±18.34)pg/ml、(41.78±22.53)pg/ml]水平均低于治疗前[(6.63±2.60)IU/L、(6.60±2.57)IU/L,(1.49±0.75)IU/L、(1.50±0.73)IU/L,(62.20±20.47)pg/ml、(61.04±24.13)pg/ml],且术后给药组患者FSH、LH及雌二醇水平高于术前给药组,差异均有统计学意义(P<0.05)。结论治疗前给药达菲林应用于OCC剥除术患者中围术期指标表现更好,治疗效果显著,自然妊娠率较高。在今后的研究中可进一步扩大样本量分析并探讨术前使用达菲林的临床优势性。Objective To investigate and analyze the effect of gonadotropin-releasing hormone agonist(GnRH-a)administered at different times on the natural pregnancy rate of patients undergoing ovarian chocolate cyst(OCC)exfoliation.Methods A retrospective study was performed on 110 cases of patients with OCC were admitted to the department of Gynecology,Binzhou Central Hospital and underwent OCC exfoliation from May 2018 to May 2019,aged(30.45±2.44)years old,ranging 25 to 34 years old.According to GnRH-a different administration times,patients were divided into the preoperative group(n=61)and postoperative group(n=49).Patients in the preoperative group were given Diphereline before surgery,and patients in the postoperative group were given Diphereline after surgery.The perioperative indexes,clinical treatment effects,sex hormone levels[follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol]before and after treatment,and natural pregnancy rate of 1 year follow-up were compared between the two groups.Results The operative time[(76.24±14.08)minutes],postoperative exhaust time[(19.32±3.81)hours],intraoperative blood loss[(45.89±8.30)ml]and abdominal drainage fluid volume[(53.23±8.12)ml]in the preoperative group were all lower than those in the postoperative group[(104.97±19.36)minutes,(22.78±4.21)hours,(60.52±12.44)ml and(60.85±11.34)ml];the complication rate[1.6%(1/61)]in the preoperative group was lower than that in the postoperative group[14.3%(7/61)],and all the differences were statistically significant(P<0.05).The total clinical effective rate in preoperative group[96.7%(59/61)]and 1-year follow-up rate of natural pregnancy[73.8%(45/61)]were higher than those in the postoperative group[85.7%(42/49)and 55.1%(27/49)],and the difference was statistically significant(P<0.05).After treatment,the levels of FSH[(3.28±1.41)IU/L,(5.09±1.53)IU/L],LH[(1.20±0.52)IU/L,(1.40±0.37)IU/L]and estradiol[(32.87±18.34)pg/ml and(41.78±22.53)pg/ml]in both groups were lower than those before treatment[(6.63±2.60)IU/L

关 键 词：促性腺激素释放激素激动剂 巧克力囊肿剥除术 自然妊娠率 达菲林 

分 类 号：R713.6[医药卫生—妇产科学]