屈螺酮炔雌醇联合宫腹腔镜探查手术治疗Ⅰ~Ⅱ期子宫内膜异位症不孕患者的临床疗效  

Clinical efficacy of drospiroone ethinylestradiol combined with laparoscopic exploratory surgery in the treatment of infertile patients with Ⅰ~Ⅱ endometriosis

作　　者：张文秋 谢李鑫 方秋香 Zhang Wen-qiu;Xie Li-xin;Fang Qiu-xiang(Department of Obstetrics and Gynecology,Maternal and Child Health Hospital of Nanzhao County,Nanyang 474650,Henan,China;Department of Obstetrics and Gynecology,Nanyang Second People's Hospital,Nanyang 474650,Henan,China)

机构地区：[1]南召县妇幼保健院妇产科,河南南阳474650 [2]南阳市第二人民医院妇产科,河南南阳474650

出　　处：《四川生理科学杂志》2021年第6期932-934,938,共4页Sichuan Journal of Physiological Sciences

摘　　要：目的:探究屈螺酮炔雌醇辅助宫腹腔镜治疗Ⅰ~Ⅱ期子宫内膜异位症(Endometriosis,EMT)不孕患者的效果。方法:选取我院2019年1月至2020年4月间收治的112例Ⅰ~Ⅱ期EMT不孕患者,随机分成两组(n=56)。所有患者均行宫腹腔镜探查手术,术后对照组患者口服孕三烯酮2.5 mg,2次·w^(-1)进行治疗,观察组患者口服屈螺酮炔雌醇1片Qd治疗。治疗3 m后评估总有效率,并测定血清雌二醇(Estradiol,E2)、卵泡刺激素(Follicle stimulating hormone,FSH)、黄体生成激素(Luteinizing hormone,LH)、血清基质金属蛋白酶-9(Matrix metallo proteinase-9,MMP-9)、糖链抗原125(Carbohydrate antigen 125,CA125)水平;同时随访1年统计两组患者妊娠率及不良反应发生率。结果:两组患者总有效率无差异(P>0.05);与治疗前相比,治疗3 m后所有患者血清E2、FSH、LH、MMP-9、CA125水平均明显降低(P<0.05),但组间对比无差异(P>0.05);而观察组妊娠率较对照组高,不良反应发生率较对照组低(P<0.05)。结论:屈螺酮炔雌醇联合宫腹腔镜探查手术治疗Ⅰ~Ⅱ期EMT不孕患者有助于提高其妊娠率,用药安全性高。Objective:To investigate the efficacy of drospiroone ethinylestradiol combined with laparoscopic exploratory surgery in the treatment of infertile patients withⅠ~Ⅱendometriosis(EMT).Methods:A total of 112 patients with EMT infertility atⅠ~Ⅱstage(January 2019~April 2020)were selected from our hospital and divided into two groups(n=56)randomly.All patients received laparoscopic exploratory surgery,and were treated with gestational trienone 2.5 mg twice every week in control group and drospirosterone ethinyl estradiol 1 tablet Qd in observe group.The total effective rate,sex hormone levels including estradiol(E2),follicle stimulating hormone(FSH),luteinizing hormone(LH),serum matrix metalloproteinase-9(MMP-9)and glycochain antigen 125(CA125)levels were measured before treatment and 3 months after treatment.The pregnancy rate and the incidence of adverse reactions were analyzed by 1-year follow-up.Results:There was no significant difference in total effective rate between two groups(P>0.05).After 3 months of treatment,the levels of serum E2,FSH,LH,MMP-9 and CA125 in the two groups were significantly lower than those before treatment(P<0.05),but there was no significant difference between the two groups(P>0.05).However,the pregnancy rate in observe group was 71.43%(40/56)higher than that in control group(50.00%,28/56)(P<0.05)and the incidence of ADR was notably lower than that in control group(17.86%,10/56)(P<0.05).Conclusion:The efficacy of drospiroone erelylestradiol or trienone combined with laparoscopic exploratory surgery in treating infertility patients withⅠ~ⅡEMT is benefit to regulate the levels of sex hormones and promote the recovery of the disease,and more effective in improving pregnancy rate and safety.

关 键 词：子宫内膜异位症不孕 屈螺酮炔雌醇 宫腹腔镜探查手术 

分 类 号：R71[医药卫生—妇产科学]