CAJ | 학술논문

目的：探讨轻度子宫内膜异位症( endometriosis, EMT)合并不孕症患者腹腔镜术后及时促排卵并指导受孕对妊娠的影响。方法将93例轻度EMT合并不孕症行腹腔镜术的患者分为研究组51例和对照组42例。研究组于术后第一个月经周期开始给予微刺激促排卵治疗,方案为氯米芬+尿促性素( human menopausal gonaclotxopin, HMG)+绒毛膜促性腺激素( human chorionic gonadotropin, HCG),B超监测排卵并指导受孕；对照组术后予期待治疗,不予促排卵,但监测排卵,受孕指导同研究组。随访术后3个月经周期,比较两组卵泡发育状况、内膜厚度、黄体功能及妊娠结局。结果研究组排卵日雌二醇( estradiol,E2)水平及排卵后黄体功能明显高于对照组(P＜0.05)；排卵日内膜厚度两组比较,差异无统计学意义(P>0.05)；术后3个月内研究组妊娠率高于对照组(39.22% vs 23.81%, P＜0.05)；研究组早期自然流产率低于对照组(P＜0.05)。结论对于轻度EMT合并不孕症患者腹腔镜术后及时促排卵治疗能改善卵泡质量及黄体功能并有效提高妊娠率、降低流产率。
목적：탐토경도자궁내막이위증( endometriosis, EMT)합병불잉증환자복강경술후급시촉배란병지도수잉대임신적영향。방법장93례경도EMT합병불잉증행복강경술적환자분위연구조51례화대조조42례。연구조우술후제일개월경주기개시급여미자격촉배란치료,방안위록미분+뇨촉성소( human menopausal gonaclotxopin, HMG)+융모막촉성선격소( human chorionic gonadotropin, HCG),B초감측배란병지도수잉；대조조술후여기대치료,불여촉배란,단감측배란,수잉지도동연구조。수방술후3개월경주기,비교량조란포발육상황、내막후도、황체공능급임신결국。결과연구조배란일자이순( estradiol,E2)수평급배란후황체공능명현고우대조조(P＜0.05)；배란일내막후도량조비교,차이무통계학의의(P>0.05)；술후3개월내연구조임신솔고우대조조(39.22% vs 23.81%, P＜0.05)；연구조조기자연유산솔저우대조조(P＜0.05)。결론대우경도EMT합병불잉증환자복강경술후급시촉배란치료능개선란포질량급황체공능병유효제고임신솔、강저유산솔。
Objective To investigate the influence of timely ovulation induction on pregnancy of infertility women with mild endometriosis ( EMT ) after laparoscopy. Methods 93 infertility women with mild EMT after laparoscopy were divided into study group ( n =51 ) and control group ( n =42 ) . The cases in study group were administrated with Clomiphene citrate tablets + HMG +HCG at the first menstrual cycle post-operation for ovulation induction under B-ultrasonic monitoring and given conceive guidance. The cases in control group were treated with expectant treatment only. All the patients were followed up for 3 months. Level of Follicular development, endometrium thickness, luteal function and pregnancy outcomes were compared between two groups. Results Estradiol level on the day of ovulation and luteal function in the study group were higher than that in the control group ( P <0. 05 ); no significant difference were found in endometrium thickness on the day of ovulation(P>0. 05); Pregnancy rates in the study group was higher than the control group(39. 22% vs 23. 81%, P<0. 05); The abortion rate in the study group was lower than the control group(P<0. 05). Conclusion Timely ovulation induction after laparoscopy surgery could significantly increase pregnancy rates and reduce abortion rates in infertility patients with mild EMT.