摘要
目的:探讨腹腔镜手术联合小剂量米非司酮治疗子宫内膜异位症合并不孕症患者的疗效。方法:选取我院2016年9月~2018年9月收治的80例子宫内膜异位症合并不孕症患者为研究对象,随机分为治疗组(40例)和对照组(40例),对照组予以腹腔镜手术治疗,治疗组在对照组的基础上予以小剂量米非司酮口服,疗程为6个月。比较两组的临床疗效、治疗前后的卵巢功能[卵泡刺激素(FSH)、雌二醇(E 2)、黄体生成素(LH)]、血清基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶组织抑制剂-1(TIMP-1)、血清脂联素(APN)、胰岛素样生长因子-1(IGF-1)及不良反应发生情况,术后随访1年,比较两组的复发率及妊娠率。结果:治疗组的临床有效率(95.00%)显著高于对照组(80.00%)(P<0.05);治疗后,治疗组的FSH、LH、APN显著高于对照组(P<0.05),E 2、TIMP-1、MMP-9、IGF-1显著低于对照组(P<0.05);治疗组的不良反应发生率为7.50%,对照组的不良反应发生率为12.50%,两组不良反应比较无统计学差异(P>0.05);治疗组的妊娠率为62.50%,复发率为10.00%,对照组的妊娠率为37.50%,复发率为32.50%,两组的妊娠率和复发率比较有统计学差异(P<0.05)。结论:腹腔镜手术联合小剂量米非司酮治疗子宫内膜异位症合并不孕症的临床效果显著,能改善卵巢功能,提高妊娠率,降低复发率。
Objective:To explore the curative effect of laparoscopic surgery combined with low-dose mifepristone on patients with endometriosis and infertility.Methods:80 patients with endometriosis and infertility who were admitted to the hospital from September 2016 to September 2018 were enrolled in the study and randomly divided into treatment group(40 cases)and control group(40 cases).Laparoscopic surgery was carried out in the control group,while low-dose mifepristone was given in the treatment group in addition to the surgery.The course of treatment was 6 months.The clinical curative effect,ovarian function[follicle stimulating hormone(FSH),estradiol(E 2)and luteinizing hormone(LH)]before and after treatment,serum matrix metalloproteinase-9(MMP-9),tissue inhibitor of metalloproteinaser-1(TIMP-1),serum adiponectin(APN),insulin-like growth factor-1(IGF-1)and occurrence of adverse reactions were compared between the two groups.The follow-up study lasted for 1 year.The recurrence rate and pregnancy rate were compared between the two groups.Results:The clinical response rate in the treatment group was significantly higher than that in the control group(95.00%vs 80.00%;P<0.05).After treatment,FSH,LH and APN of treatment group were significantly higher than those of control group(P<0.05),while E 2,TIMP-1,MMP-9 and IGF-1 were significantly lower than those of control group(P<0.05).There was no significant difference in incidence of adverse reactions between treatment and control groups(7.50%vs 12.50%).There were significant differences in pregnancy rate and recurrence rate between treatment and control groups(62.50%,10.00%vs 37.50%,32.50%;P<0.05).Conclusion:The clinical curative effect of laparoscopic surgery combined with low-dose mifepristone in the treatment of endometriosis and infertility is significant,which is shown in the improved ovarian function,improved pregnancy rate and reduced recurrence rate.
作者
冯元元
赵子雄
FENG Yuan-yuan;ZHAO Zi-xiong(Department of Obstetrics and Gynecology of Xinyang Central Hospital,Xinyang 464000,China;Department of Obstetrics and Gynecology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中国合理用药探索》
CAS
2020年第2期48-53,共6页
Chinese Journal of Rational Drug Use
基金
河南省医学科技攻关计划项目(201702015)
