[1]苏胜红.子宫内膜异位症合并不孕患者腹腔镜术后联合药物治疗对妊娠结局的影响[J].中国计划生育和妇产科,2018,(１):32-36.
　SU Sheng-hong.Effect of laparoscopic surgery combined drug therapy on pregnancy outcome in patients with endometriosis complicated with infertility[J].Chinese Journal of Family Planning & Gynecotokology,2018,(１):32-36.
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子宫内膜异位症合并不孕患者腹腔镜术后联合药物治疗对妊娠结局的影响
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2018年１期
页码:
32-36
栏目:
论著与临床
出版日期:
2018-01-25

文章信息/Info

Title:
Effect of laparoscopic surgery combined drug therapy on pregnancy outcome in patients with endometriosis complicated with infertility
作者:
苏胜红
广西医科大学第七附属医院生殖中心
Author(s):
SU Sheng-hong
Reproductive Center，the 7th Affiliated Hospital of Guangxi Medical University，Wuzhou Guangxi 543001，P.R.China
关键词:
子宫内膜异位症; 不孕症; 药物治疗; 腹腔镜手术; 妊娠结局
Keywords:
endometriosis;  infertility;  drug therapy;  laparoscopic surgery;  pregnancy outcome
分类号:
R 711.71
摘要:
目的探讨腹腔镜术后联合药物治疗对改善子宫内膜异位症（endometriosis, EMT）合并不孕患者妊娠结局的效果。方法选取广西医科大学第七附属医院2012年1月至2017年1月收治的78例EMT合并不孕患者，所有患者均行腹腔镜手术治疗，术后进行美国生育协会（Retrospective American Fertility Association，r-AFS）分期，按照随机、单盲对照法，将患者平均分为曲瑞普林组（26例）、孕三烯酮组（26例）和米非司酮组（26例），分别给予醋酸曲瑞普林、孕三烯酮片及米非司酮片治疗，分析不同r-AFS分期、不同药物治疗与妊娠结局的关系。结果① 妊娠成功率：78例患者妊娠成功率为5128 %（40/78）；不同r-AFS分期患者妊娠率分别为I期6400 %（16/25）、Ⅱ期5294 %（18/34）、Ⅲ期2727 %（3/11）、Ⅳ期3750 %（3/8），差异无统计学意义（P>005）；妊娠率曲瑞普林组为7692 %（20/26），孕三烯酮组为4615 %（12/26），米非司酮组为3077 %（8/26），曲瑞普林组妊娠率高于其他两组（P<005）。② 妊娠结局：不同r-AFS分期患者妊娠良好结局与不良结局比较差异无统计学意义（P>005）；曲瑞普林组患者妊娠不良结局发生率（1000 %）低于其他两组（分别为4167 %、6250 %）（P<005）。结论EMT患者不同r-AFS分期对妊娠成功率及妊娠结局无明显影响，腹腔镜术后联合促性腺激素释放激素激动剂可以提高患者妊娠成功率，降低不良妊娠结局发生率。
Abstract:
ObjectiveTo investigate the effect of laparoscopic surgery combined with drug therapy on pregnancy outcome in patients with endometriosis（EMT） complicated with infertility. MethodsA total of 78 patients with EMT complicated with infertility were enrolled in the 7th Affiliated Hospital of Guangxi Medical University from January 2012 to January 2017. All patients underwent laparoscopic surgery. The r-AFS staging was performed，and the patients were divided into triptorelin group(26 cases), gestrinone group(26 cases) and mifepristone group(26 cases) according to randomized, single-blind control. They were given triptorelin acetate, gestrinone tablets and mifepristone tablets treatment, respectively. The relationship between different r-AFS staging, different drug treatment and pregnancy outcome was analyzed. Results① Comparison of pregnancy success rate: pregnancy success rate of 78 cases was 5128%(40/78); The pregnancy rate of patients with different r-AFS staging was 6400% (16/25) in phase I, 5294% in phase II (18/34), 2727% in stage III (stage 3) and 3750% (3/8) in stage IV .There was no significant differences (P> 005).The pregnancy rate was 7692% (20/26) in the triamcinolone group and 4615% (12/26) in the gestrinone group. The pregnancy rate of the mifepristone group was 3077% (8/26) ; The pregnancy rate of the Ruplin group was significantly higher than that of the other two groups(P<005); ② Comparison of pregnancy outcome: There were no significant differences in gestational outcomes and adverse outcomes between different r-AFS staging patients; The incidence of adverse pregnancy outcome in the triamcinolone group was lower than that in the other two groups (4167%, 6250%, respectively), the differences were statistically significant(P<005). ConclusionDifferent r-AFS staging in patients with endometriosis has no significant effect on pregnancy success rate and pregnancy outcome. Laparoscopic combined with gonadotropin-releasing hormone agonists can improve the success rate of pregnancy and reduce the incidence of adverse pregnancy events.

参考文献/References:

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更新日期/Last Update: 2018-01-25