摘要
目的:观察和比较开腹剥除术、腹腔镜剥除术及超声引导穿刺术对子宫内膜异位囊肿伴不孕症患者卵巢功能的影响。方法:选取2011年1月-2013年6月我院收治的子宫内膜异位囊肿伴不孕症患者168例,根据患者手术治疗方案分为A、B、C三组,A组患者应用开腹剥除术,B组患者行腹腔镜剥除术,C组给予超声引导穿刺术治疗,对比三组患者手术前后促卵泡成熟激素(FSH)、黄体生成激素(LH)、雌二醇(E2)及窦卵泡数目(AFC)等卵巢储备功能指标水平的变化、临床妊娠数、流产情况及术后复发率。结果:治疗后,三组患者AFC数量均较治疗前显著下降(P<0.05),且C组AFC显著高于B、A两组(P<0.05);三组患者治疗后血清FSH、E2、FSH/LH水平均较治疗前显著提高,A组血清FSH、E2、FSH/LH水平明显高于B、C组,而C组血清FSH、E2、FSH/LH水平明显高于B组(P<0.05)。术后1、2、3年,A组妊娠率均显著低于B、C组(P<0.05),且自然流产率显著高于B、C两组(P<0.05),而B、C组妊娠率和自然流产率相比差异均无统计学意义(P>0.05)。结论:应用超声引导穿刺术及腹腔镜剥除术治疗子宫内膜异位囊肿伴不孕症患者对其卵巢储备功能影响均较小,且妊娠情况较好,临床可根据患者情况选择恰当手术方式,以提高治疗效果。
Objective： To observe and compare the influence of open abdominal surgery, laparoscopic stripping, ultrasound-guid- ed puncture on the ovarian function of patients with endometriosis cyst complicated with infertility. Methods： 168 eases of patients with endometriosis cyst complicated with infertility treated in our hospital from January 2011 to June 2013 were selected and divided into group A, group B and group C according to the surgical treatment plans. Group A was treated with open stripping, group B was treated with laparoscopic stripping, and group C was treated with ultrasound-guided puncture. The changes of serum FSH, LH, E2 and AFC and other indicators of ovarian reserve function levels clinical pregnancy, abortion and recurrence rate were compared between three groups. Results： After treatment, the number of AFC were all decreased in the three groups compared with that before treatment, which was sig- nificantly higher in group C than those of group B and group A （P〈0.05）. After treatment, the serum FSH, E2, FSH, E2 and FSI-I/LH levels in the three groups were increased than those before treatment （P〈0.05）. The serum FSH, E2, FSH and FSH/LH levels of group A were sig- nificantly higher than those of group B and group C, and those in C group were significantly higher than those in group B （P〈0.05）. At 1, 2, 3 years after operation, the pregnancy rates of group A were significantly lower than those in group B and group C（P〈0.05）, and spun- taneous abortion rate was significantly higher than that orB and C groups （P〈0.05）. There was no significant difference in the pregnancy rate and spontaneous abortion rate between group B and group C （P〉0.05）. Conclusion： Ultrasound guided puncture and laparoscopic enucleation had smaller influence on the ovarian reserve function and better pregnancy in the treatment of patients with endometriosis cyst complicated with infertility. It should be chosen appropriate surgical way according to the patients in the clinic in order to improve the treatment effect.
出处
《现代生物医学进展》
CAS
2017年第29期5665-5668,共4页
Progress in Modern Biomedicine
基金
江苏省自然科学基金项目(SJ970572)
