仿生物电刺激治疗对薄型子宫内膜不孕症患者再妊娠的有效性及安全性  

Efficacy and safety of biomimetic electrical stimulation in re-pregnancy of patients with thin endometrium infertility

作　　者：张苗[1] 曾玉华[1] 陈小芬[1] 李蕊[1] 周洪贵[1] 刘春蓉[1] ZHANG Miao;ZENG Yuhua;CHEN Xiaofen;LI Rui;ZHOU Honggui;LIU Chunrong(Department of Obstetrics and Gynecology,The Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China)

机构地区：[1]川北医学院附属医院妇产科,四川南充637000

出　　处：《西部医学》2023年第9期1357-1362,共6页Medical Journal of West China

基　　金：2018年南充市市校合作科研专项项目(18XHZ0529)。

摘　　要：目的探究仿生物电刺激治疗薄型子宫内膜不孕症患者后再次妊娠的有效性及对胚胎的安全性。方法采用前瞻性非随机对照研究选取本院2020年1月—2021年3月诊断为薄型子宫内膜不孕症的72例患者为研究对象,根据患者治疗意愿选择芬吗通治疗组(对照组)和电刺激阴道+穴位(中极、关元、足三里、三阴交、太冲、肾俞)联合芬吗通组(观察组),每组各36例,治疗时间为3个排卵周期,比较两组治疗前后的盆底肌肌力、子宫内膜容受性、再妊娠及孕产结局等临床数据。结果治疗后,观察组患者盆底肌肌力,子宫内膜容受性,再妊娠率均有改善,盆底肌I类肌纤维及Ⅱ类肌纤维肌力有明显提升,且子宫动脉血流RI值较观察组显著降低(均P<0.05),再妊娠率高于对照组,差异具有统计学意义(P<0.05);两组子宫内膜厚度及A型子宫内膜形态比例均有所增加但差异不明显(P>0.05),两组无创产前检测、剖宫产率、产时出血量、胎儿Apgar评分无明显差异(P>0.05)。两组治疗期间无严重不良反应,妊娠期主要并发症为妊娠期糖尿病。结论薄型子宫内膜不孕症患者盆底肌肌力差,联合穴位、药物阴道电刺激能够促进盆腔血液循环,改善盆底肌力及子宫内膜容受性,提高再妊娠率,不增加不良妊娠的发生,治疗安全有效。Objective To investigate the efficacy and embryo safety of biomimetic electrical stimulation in the treatment of thin endometrial infertility.Methods A prospective non randomized controlled study was conducted to select 72 patients with thin endometrial infertility diagnosed in the Affiliated Hospital of North Sichuan Medical College from January 2020 to March 2021 as the research objects.According to the treatment willingness of the patients,36 patients were selected in the fenmotong treatment group(control group)and the combination of electric stimulation of vagina+acupoints(Zhongji,Guanyuan,Zusanli,Sanyinjiao,Taichong,Shenshu)and fenmotong group(observation group).The treatment time was three ovulation cycles.The clinical data of pelvic floor muscle strength,endometrial receptivity,re-pregnancy and pregnancy outcome were compared between the two groups before and after treatment.Results After treatment,the pelvic floor muscle strength,endometrial receptivity,and re-pregnancy rate in the observation group were improved(P<0.05),the pelvic floor muscle class I muscle fiber and class II muscle fiber strength were significantly increased(P<0.05),and the RI value of uterine artery blood flow was significantly lower than that in the observation group(P<0.05),and the re-pregnancy rate was higher than that in the control group(P<0.05);However,the endometrial thickness and the proportion of type a endometrial morphology in the two groups increased,but the difference was not significant(P>0.05).There was no significant difference between the two groups in non-invasive prenatal testing,cesarean section rate,intrapartum bleeding volume and fetal Apgar score(P>0.05).However,there were no serious adverse reactions in the two groups during treatment,and the main complication during pregnancy was gestational diabetes.Conclusion Pelvic floor muscle strength is poor in patients with thin endometrial infertility.Combined acupoint and drug vaginal electrical stimulation can promote pelvic blood circulation,improve pelvic floor mus

关 键 词：仿生物电刺激 薄型子宫内膜 不孕症 穴位 再妊娠 

分 类 号：R711.6[医药卫生—妇产科学]