CAJ | 학술논문

目的探讨激素替代周期子宫内膜微创术在卵巢早衰患者治疗中的应用。方法选取2012年9月至2013年9月收治卵巢早衰患者4例（观察组），所有患者均行激素替代周期子宫内膜微创术，同时选择同期因男性因素不孕，正常月经期妇女9例（对照组）。将两组子宫内膜胞饮突在种植窗口期的情况进行观察，回顾临床资料。结果观察组在行子宫内膜微创术前，低倍镜下子宫内膜上皮呈紊乱排列，纤毛细胞部分纤毛呈缺如显示，高倍镜下隐约见微绒毛发育蔫小，微绒毛细胞和纤毛细胞皱缩，呈微量胞饮突表达。对照组患者分泌期子宫内膜有明显皱褶，表面光滑，有大量呈圆形腺体开口。胞饮突在腺体开口处较丰富，子宫内膜上皮细胞呈有序排列，胞饮突饱满圆润，纤毛细胞发育旺盛。9例正常组，处于衰退期1例、发育中阶段2例，发育完全成熟阶段6例。治疗后观察组4例术后均妊娠，3例均为单胎，孕期顺利，1例双胎，孕13周流产。结论赠卵移植反复失败的卵巢早衰患者，实施子宫内膜微创术可使子宫内膜容受性改善。子宫内膜容受性可用胞饮突来评价。
목적탐토격소체대주기자궁내막미창술재란소조쇠환자치료중적응용。방법선취2012년9월지2013년9월수치란소조쇠환자4례（관찰조），소유환자균행격소체대주기자궁내막미창술，동시선택동기인남성인소불잉，정상월경기부녀9례（대조조）。장량조자궁내막포음돌재충식창구기적정황진행관찰，회고림상자료。결과관찰조재행자궁내막미창술전，저배경하자궁내막상피정문란배렬，섬모세포부분섬모정결여현시，고배경하은약견미융모발육언소，미융모세포화섬모세포추축，정미량포음돌표체。대조조환자분비기자궁내막유명현추습，표면광활，유대량정원형선체개구。포음돌재선체개구처교봉부，자궁내막상피세포정유서배렬，포음돌포만원윤，섬모세포발육왕성。9례정상조，처우쇠퇴기1례、발육중계단2례，발육완전성숙계단6례。치료후관찰조4례술후균임신，3례균위단태，잉기순리，1례쌍태，잉13주유산。결론증란이식반복실패적란소조쇠환자，실시자궁내막미창술가사자궁내막용수성개선。자궁내막용수성가용포음돌래평개。
Objective To evaluate minimally endometrial invasive surgery during hormone replacement cycle in patients with premature o-varian failure. Methods Four cases of premature ovarian failure who underwent minimally endometrial invasive surgery during hormone replace-ment cycle in our hospital from September 2012 to September 2013 were selected as study group;9 women with normal menstrual period and male factor infertility were in control group. The endometrial pinopode during implantation window period and clinical outcomes of the patients were ob-served. Results In observation group,before minimally endometrial invasive surgery,endometrial epithelium had irregular arrangement,and part of the cilia of ciliated cells were absent in low magnification;and small microvilli,shrinked microvilli and ciliated cells,and trace pinopode ex-pression were observed in high magnification. In control group,secretory endometrium had significantly wrinkled,smooth surface,a large circular gland openings and abundant pinopode in the gland openings,endometrial epithelial cells were ordered,pinopodes were full round,ciliated cells were well developed. Of 9 normal women,recession was found in one,developmental stages in two,fully developed mature stage in six. After treatment,the pregnancy outcomes in observation group were all 4 patients were pregnanted including single pregnancy in 3 and twin pregnancy in one;abortion occurred in the twin pregnancy at 13 weeks. Conclusion The implementation of minimally invasive endometrial surgery can im-prove endometrial receptivity in patients with recurrent failure of oocyte donation transplantation and premature ovarian failure. Pinopodes can be used for the evaluation of endometrial receptivity and clinical treatment.