腹腔镜下改良锐性剥离术对卵巢EMs患者的疗效及对其卵巢功能和妊娠率的影响分析

Analysis of Clinical efficacy、ovarian function and pregnancy rate with modified sharp peeling treatment on EMs patients

目的:探讨腹腔镜下改良锐性剥离术对卵巢EMs患者的疗效及对其卵巢功能和妊娠率的影响分析。方法:选取我科收治的110例卵巢EMs患者,根据手术治疗方式的不同,分为研究组及对照组两组(各55例),其中研究组(采用腹腔镜下改良锐性剥离术治疗)和对照组(采用腹腔镜下常规钝性剔除术治疗),比较2组患者的临床疗效等差异。结果:后两组患者卵巢窝及中间皮质剥除率比较均无统计学差异;而研究组患者的卵巢门皮质剥除率显著低于对照组;术前两组患者患侧卵巢窦卵泡数及卵巢体积比较无差异,而术后半年,两组患者患侧卵巢体积均较术前明显缩小且对照组缩小程度显著大于研究组,而研究组患侧窦卵泡数与术前比较无差异,但显著多于对照组;手术前后两组患者的相关血清性激素指标水平比较均无差异;术前两组患者的相关血清卵巢储备功能指标水平比较无差异,而术后研究组患者的相关血清卵巢储备功能指标水平均较对照组改善明显;术后1年研究组患者的妊娠率(76.4%)显著高于对照组患者(54.5%)。结论:腹腔镜下改良锐性剥离术式治疗EMs患者的疗效显著,不仅可有效降低卵巢门皮质剥除率及卵泡的丢失程度,同时还能改善AMH及抑制素B水平,最终有助于提高患者妊娠率,因此值得临床推广应用。

Objective To investigate the analysis of Clinical efficacy、ovarian function and pregnancy rate with modified sharp peeling treatment on EMs patients.Methods To screening 110 cases of EMs patients as research subjects,it will be divided into study group(55 cases)with modified acute elimination and control group(55 cases)with conventional blunt elimination,then the two groups were compared in terms of clinical efficacy and so on.Results The cortical ablation rate in hilus ovarii of study group was significantly lower than that of control group;The antral follicle count of affected side and ovary volume of study group after operation were significantly higher than those of control group;There were no significant differences in the levels of FSH,LH and E2 before and after treatment between the two groups;The serum Inhibin B and Anti-Mullerian hormon levels in study group were better than the control group after treatment;The pregnancy rate in 1 year after operation of study group was significantly higher than that of control group.Conclusion Ovarian endometriosis patients with laparoscopic modified sharp peeling treatment not only effectively peel off the close adhesion of the ovarian door near the wall tissue,but also improve the serum Inhibin B and Anti-Mullerian hormon levels and pregnancy rate,it is worthy of popularization and application.