小儿腹腔镜在青春期及青春期前重型地中海贫血患儿生育力保存中的应用及可行性分析  

Feasibility Analysis and Application of Pediatric Laparoscopy in the Fertility Preservation in Pubertal and Prepubertal Patients with Thalassemia Major

作　　者：陈攀宇[1] 李满超[1] 孙鹏[1] 李晶洁[1] 颜禄斌[2] 方丛[1] 王德娟 梁晓燕[1] CHEN Pan-yu;LI Man-chao;SUN Peng;LI Jing-jie;YAN Lu-bin;FANG Cong;WANG De-juan;LIANG Xiao-yan(Reproductive Medicine Center,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510655,China;Department of Pediatric Surgery,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510655,China;Department of Urinary Surgery,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510655,China)

机构地区：[1]中山大学附属第六医院生殖医学研究中心,广东广州510655 [2]中山大学附属第六医院小儿外科,广东广州510655 [3]中山大学附属第六医院泌尿外科,广东广州510655

出　　处：《中山大学学报（医学科学版）》2022年第5期764-771,共8页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：国家自然科学基金(82071713)。

摘　　要：【目的】分析青春期及青春期前重度β-地中海贫血(TM)患儿生育力保存行小儿腹腔镜的术中及术后情况,进一步探讨小儿腹腔镜在生育力保存手术中的应用前景。【方法】对13例青春期及青春期前拟行造血干细胞移植的TM患者通过小儿腹腔镜获取卵巢组织行卵巢组织冷冻(OTC)合并卵子体外成熟(IVM)行生育力保存的病例进行分析,探索小儿腹腔镜在生育力保存手术中的安全性及可行性。【结果】13名患儿的手术方式均为腹腔镜下单侧卵巢切除,平均手术时长(58.31±20.25)min,术中平均出血(2.46±1.13)mL,13例手术术后均无并发症,平均住院日为(3.62±1.33)d。13例患儿均成功获得卵巢组织可供冷冻,平均冷冻卵巢组织7.77±2.31片;其中11名患儿同时获得成熟卵母细胞可供冷冻,平均冷冻卵母细胞4.92±4.27枚。【结论】小儿腹腔镜获取卵巢组织是安全有效的生育力保存术式,可在青春期及青春期前血液疾病患者中大力推广。【Objective】The purpose of this study is to analyze the intraoperative and postoperative conditions of pediat⁃ric laparoscopy in fertility preservation in pubertal and prepubertal patients withβ-thalassemia major(TM)and to further explore the prospects of pediatric laparoscopy in fertility preservation surgery.【Methods】Totally 13 pubertal and prepuber⁃tal patients withβ-TM who underwent ovarian tissue cryopreservation(OTC)combined with in vitro maturation(IVM)for fertility preservation through pediatric laparoscopic acquisition of ovarian tissue before hematopoietic stem cell transplanta⁃tion were analyzed.【Results】All 13 children underwent laparoscopic unilateral oophorectomy,with an average operative time of(58.31±20.25)minutes and an average intraoperative bleeding of(2.46±1.13)mL.All 13 children had no postop erative complications and an average hospital stay of(3.62±1.33)days.All children had ovarian tissue available for cryopreservation;the average pieces of ovarian tissue frozen was 7.77±2.31.Eleven of them also had mature oocytes avail⁃able for cryopreservation;the average number of oocytes frozen was 4.92±4.27.【Conclusion】Pediatric laparoscopic is a safe and effective fertility-preserving procedure that can be strongly promoted in pubertal and prepubertal patients withβ-TM.

关 键 词：小儿腹腔镜 重型地中海贫血 生育力保存 卵巢组织 

分 类 号：R726.1[医药卫生—儿科]