摘要
目的 :比较子宫内膜异位症伴不孕不同治疗方法的疗效。方法 :197例患者中Ⅰ期 85例 (4 3.1% ) ,Ⅱ期 6 5例 (33.0 % ) ,Ⅲ期 2 8例 (14 .2 % ) ,Ⅳ期 19例 (9.6 % )。将Ⅰ、Ⅱ期患者分为 7组 ,分别采用三苯氧胺、米非司酮、丹那唑、诺雷德、10 0℃以下异位病灶热破、安慰剂治疗 (每组 2 1± 1例 ) ;下余 1组与Ⅲ、Ⅳ期患者采用两阶段复合治疗 ,即先破坏子宫内膜异位病灶 ,切除卵巢囊肿 ,分离粘连 ;再用丹那唑治疗 6个月。观察 1年并进行比较。结果 :Ⅰ、Ⅱ期患者用三苯氧胺、米非司酮、丹那唑、诺雷德、热破、两阶段复合治疗、安慰剂治疗 ,其受孕率分别为 34%、38%、5 4%、5 2 %、4 2 %、5 2 .6 %、8.1% ;Ⅲ、Ⅳ期患者治疗后的受孕率分别为 4 5 .6 %、4 8.7%。妊娠率动态分析显示最易受孕的时间是在治疗完成后的 6～ 8个月。结论 :子宫内膜异位伴不孕症不论其病情发展程度 ,都须积极治疗。最佳的治疗方法是用促性腺制剂及两阶段复合治疗。
Objective:To compare the effect and value of different therapeutic regime in infertility women with endometriosis.Methods:Among the 197 patients,85(43.1%)cases were in phase Ⅰ, 65(33.0%)cases were in phase Ⅱ, 28(14.2%)cases were in phase Ⅲ and the rest 19(9.6%)cases were in phase Ⅳ.150 cases of phase Ⅰ and phase Ⅱ were divided into 7 groups randomly. Six groups ( 21±1 case each group ) were treated with tamoxifen, mifepristone,danazol,zoladex,destroy the focus by heating but no more than 100℃ or treated with placebo respectively, the seventh group and the Ⅲ～Ⅳ patients were treated by two step compound therapy, the first step was to destroy the focus, cut off ovarian cyst and separate the adherent tissue, then treated with danazol for 6 months. All patients were followed up and observed for one year to evaluate the effect and value.Results:Patients in Ⅰ、Ⅱ phase treated by tamoxifen, mifepristone, danazol, zoladex, destroying the focus by heating, two step therapy and placebo got a fertilizing rate of 34%,38%,54%,52%,42%,52.6%,8.1% respectively.Ⅲ phase patients′ fertilizing rate was 45.6% and Ⅳ phase patients′ was 48.7%. The dynamic analysis showed that the optimal time for fertilizing was 6～8 months after the therapies were finished.Conclusion:The infertility patients with endometriosis should be treated actively without considering their states.The suitable therapy is gonadotropic agents or two step compound therapy.The optimal observed period is 12 months.
出处
《现代妇产科进展》
CSCD
2004年第5期340-341,共2页
Progress in Obstetrics and Gynecology
