中华妇产科杂志
中華婦產科雜誌
중화부산과잡지
CHINESE JOUNAL OF OBSTETRICS AND GYNECOLOGY
2010年
4期
264-268
,共5页
关菁%沈浣%刘亚南%郑兴邦
關菁%瀋浣%劉亞南%鄭興邦
관정%침완%류아남%정흥방
子宫内膜异位症%不育,女(雌)性%腹腔镜检查%促性腺素释放激素%生育力
子宮內膜異位癥%不育,女(雌)性%腹腔鏡檢查%促性腺素釋放激素%生育力
자궁내막이위증%불육,녀(자)성%복강경검사%촉성선소석방격소%생육력
Endometriosis%Infertility,female%Laparoscopy%Gonadotropin-releasing hormone%Fertility
目的 探讨Ⅰ期子官内膜异佗症(内异症)不孕患者腹腔镜术后应用促性腺激素释放激素激动剂(GnRH-a)辅助治疗对生育能力的影响.方法 选择2006年1月-2008年6月于北京大学人民医院经腹腔镜证实为Ⅰ期内异症(即微小病变内异症)并排除其他不孕因素的不孕患者102例,经宫腔镜检查及腹腔镜盆腔内异症病灶电凝术后,根据患者意愿分为GnRH-a组60例和财照组42例,GnRH-a组于腹腔镜术后肌内注射GnRH-a 1-2次,每次3.6 mg;对照组不采用GnRH-a治疗.所有患者术后随访24个月,比较两组患者的妊娠结局及生育能力(定义为每月每100例中妊娠的例数,以百分率表示).结果 GnRH-a组的总临床妊娠率为78%(47/60),高于对照组[55%(23/42)],差异有统计学意义(χ~2=6.376,P=0.012);GnRH-a组的流产率为19%(9/47),对照组为13%(3/23),两组间比较,差异尤统计学意义(χ~2=0.089,P=0.465).GnRH-a组及对照组术后月生育能力分别为6.17%和3.26%,两组间相对危险度(RR)比值为1.9(95%CI:1.1～3.0).结论 Ⅰ期内异症患者经腹腔镜治疗后应用小剂量GnRH-a可提高术后妊娠率及生育能力.
目的 探討Ⅰ期子官內膜異佗癥(內異癥)不孕患者腹腔鏡術後應用促性腺激素釋放激素激動劑(GnRH-a)輔助治療對生育能力的影響.方法 選擇2006年1月-2008年6月于北京大學人民醫院經腹腔鏡證實為Ⅰ期內異癥(即微小病變內異癥)併排除其他不孕因素的不孕患者102例,經宮腔鏡檢查及腹腔鏡盆腔內異癥病竈電凝術後,根據患者意願分為GnRH-a組60例和財照組42例,GnRH-a組于腹腔鏡術後肌內註射GnRH-a 1-2次,每次3.6 mg;對照組不採用GnRH-a治療.所有患者術後隨訪24箇月,比較兩組患者的妊娠結跼及生育能力(定義為每月每100例中妊娠的例數,以百分率錶示).結果 GnRH-a組的總臨床妊娠率為78%(47/60),高于對照組[55%(23/42)],差異有統計學意義(χ~2=6.376,P=0.012);GnRH-a組的流產率為19%(9/47),對照組為13%(3/23),兩組間比較,差異尤統計學意義(χ~2=0.089,P=0.465).GnRH-a組及對照組術後月生育能力分彆為6.17%和3.26%,兩組間相對危險度(RR)比值為1.9(95%CI:1.1～3.0).結論 Ⅰ期內異癥患者經腹腔鏡治療後應用小劑量GnRH-a可提高術後妊娠率及生育能力.
목적 탐토Ⅰ기자관내막이타증(내이증)불잉환자복강경술후응용촉성선격소석방격소격동제(GnRH-a)보조치료대생육능력적영향.방법 선택2006년1월-2008년6월우북경대학인민의원경복강경증실위Ⅰ기내이증(즉미소병변내이증)병배제기타불잉인소적불잉환자102례,경궁강경검사급복강경분강내이증병조전응술후,근거환자의원분위GnRH-a조60례화재조조42례,GnRH-a조우복강경술후기내주사GnRH-a 1-2차,매차3.6 mg;대조조불채용GnRH-a치료.소유환자술후수방24개월,비교량조환자적임신결국급생육능력(정의위매월매100례중임신적례수,이백분솔표시).결과 GnRH-a조적총림상임신솔위78%(47/60),고우대조조[55%(23/42)],차이유통계학의의(χ~2=6.376,P=0.012);GnRH-a조적유산솔위19%(9/47),대조조위13%(3/23),량조간비교,차이우통계학의의(χ~2=0.089,P=0.465).GnRH-a조급대조조술후월생육능력분별위6.17%화3.26%,량조간상대위험도(RR)비치위1.9(95%CI:1.1～3.0).결론 Ⅰ기내이증환자경복강경치료후응용소제량GnRH-a가제고술후임신솔급생육능력.
Objective To investigate the impact on fertility potential of patients with stage Ⅰ endometriosis treated by gonadotropin-releasing hormone agonist (GnRH-a) treatment followed by laparoscopy surgery.Methods From Jan.2006 to Jun.2008, medical documents of 102 patients with minimal or mild endometriosis (stage Ⅰ) treated by laparoscopy and hysteroscopy surgery and excluded the other causes of infertility were reviewed retrospectively in Peking University People's Hospital.The pelvic endometriosis teisions were destructed by electric burning.Those patients were divided into GnRH-a treatment group(n = 60) and non-GnRH-a treatment group(n = 42) after surgery.The patients in GnRH-a treatment group were administered by GnRH-a injection once or twice after surgery, in the mean time, no adjuvant therapy were given for the patients in the other group.All the patients were followed-up for 24 months after surgery to evaluate the effect of postoperative GnRH-a treatment on pregnancy outcome and fertility potential(number of pregnancy per 100 women in one month, expressed as percentage).Results The total pregnancy rate of 78% (47/60) in GnRH-a treatment group is significantly higher than 55% (23/42) in non-GnRH-a treatment group(P =0.012).There is no significant difference in spontaneous abortion rate between the GnRH-a treatment group and non GnRH-a treatment group(19% vs.13%, P = 0.465).The fecundity rate of were 6.17% in GnRH-a treatment group and 3.26% in non-GnRH-a treatment group, which the relative risk is 1.9 (95% CI: 1.1-3.0).Conclusion Low-dose GnRH-a treatment after laparuscopy can improve the pregnancy rate and fertility potential of patients with stage Ⅰ endometriosis.
