摘要
目的探讨腹腔镜手术联合不同药物治疗轻度子宫内膜异位症(内异症)合并不孕的疗效。方法回顾性分析2004年1月～2009年12月110例腹腔镜诊断轻度内异症(r-AFSⅠ～Ⅱ期)合并不孕患者的临床资料,按术后使用药物情况分为2组:避孕药组53例,服用口服避孕药去氧孕烯炔雌醇片(妈富隆)或屈螺酮炔雌醇片(优思明)每天1片×21天,月经来潮第1天开始服药,连用3个月;孕三烯酮组57例,服用孕三烯酮每次2.5 mg,每周2次,连用3个月。比较2组术后妊娠情况和妊娠结局。结果其中104例完成3个月药物治疗,术后随访时间(24.0±8.2)月(11～41个月),妊娠率39.4%(41/104),活产率35.6%(37/104)。术后1年内、1～2年和2年以上的妊娠率分别为26.9%(28/104)、12.2%(9/74)和9.1%(4/44),术后1年的妊娠率明显高于1～2年及2年以上者(χ2=5.721,P=0.017;χ2=5.802,P=0.016)。2组妊娠率[46.0%(23/50)vs.33.3%(18/54),χ2=1.744,P=0.187]和活产率[42.0%(21/50)vs.29.6%(16/54),χ2=1.733,P=0.188]差异无显著性。结论对于合并轻度内异症的不孕患者,腹腔镜联合术后孕三烯酮或口服避孕药治疗均有效改善其生育力。
Objective To evaluate the effectiveness of laparoscopic surgery combined with gestrinone or oral contraceptive pills（OCP） in the treatment of infertile women with minimal-mild endometriosis（EMs）.Methods A retrospective analysis on the clinical materials and follow-up pregnant outcomes of 110 infertile women with minimal-mild EMs,who were treated in our hospital from January 2004 to December 2009.Gestrinone（n=57） or OCP（n=53） was administered for three months after laparoscopic surgery.In OCP group,the patients received Marvelon or Yasmin 1 tablet/d × 21 days,started from the first day of a period.While in gestrinone group,gestrinone 2.5 mg twice a week was given. Results Among these 110 cases,104 patient finished the treatment [mean follow-up（24.0±8.2） months,ranged from 11 to 41 months],the pregnancy rate and live birth rate was 39.4%（41/104） and 35.6%（37/104） respectively.The less-than-1-year pregnancy rate was 26.9%（28/104）,which was significantly higher than that at 1-2,and over 2 years [12.2%（9/74）,χ2=5.721,P=0.017 and 9.1%（4/44）,χ2=5.802,P=0.016,respectively].No significant difference was found in the pregnancy rate and live birth rate between the two groups [46.0%（23/50） vs.33.3%（18/54）,χ2=1.744,P=0.187;and 42.0%（21/50） vs.29.6%（16/54）,χ2=1.733,P=0.188,respectively].Conclusion After laparoscopic surgery,either gestrinone or OCP can improve the fecundity in infertile women with minimal-mild EMs.
出处
《中国微创外科杂志》
CSCD
2011年第5期415-417,共3页
Chinese Journal of Minimally Invasive Surgery
