囊肿核摘除术联合促性腺激素释放激素激动剂对卵巢囊肿患者卵巢储备功能及妊娠结果的影响

Effect of combined therapy of cyst and nuclear extraction and gonadotropin-releasing hormone agonists on ovarian reserve function and pregnancy outcome in patients with ovarian cyst

目的探讨囊肿核摘除术联合促性腺激素释放激素激动剂(GnHR-a)对卵巢囊肿患者卵巢储备功能及妊娠结果的影响。方法选取2013年7月至2015年7月间临朐县人民医院收治的120例卵巢囊肿患者,按照是否接受手术联合治疗分为观察组和对照组,每组60例。再将两组患者按照手术类型分为双侧囊肿核摘除术组与单侧囊肿核摘除术组,每组各30例。对比各组窦卵泡数、GnRHa天数、促性腺激素(Gn)支数、人绒毛膜促性腺激素(HCG)注射日E_2、卵泡数、卵子数、好胚数、冷冻数、移植数、妊娠率、流产率、分娩率和着床率。结果双侧囊肿核摘除对照组与双侧囊肿摘除观察组相比,窦卵泡数减少、Gn支数增加、HCG注射日E_2水平降低、卵泡数、卵子数、好胚数、冷冻数、移植数均减少,差异均有统计学意义(均P<0.05)。双侧囊肿核摘除对照组与双侧囊肿摘除观察组妊娠率、流产率和分娩率比较,差异无统计学意义(P>0.05)。单侧囊肿核摘除联合GnHR-a治疗观察组与单侧囊肿核摘除对照组比较,窦卵泡数减少、Cn支数增加、卵泡数减少、卵子数减少,差异有统计学意义(P<0.05)。单侧囊肿核摘除联合GnHR-a治疗观察组与单侧囊肿摘除对照组比较,HCG注射日E_2水平、好胚数、冷冻数、移植数、妊娠率、流产率、分娩率的差异均无统计学意义(均P>0.05)。结论单侧或双侧囊肿核摘除术均可对患者的卵巢储备功能造成影响,联合GnHR-a治疗可明显改善生殖功能下降情况,且不影响生育能力,应引起临床工作者的重视。

Objective To explore the effect of combined therapy of cyst and nuclear extraction and gonadotropin-releasing hormone agonists （GnHR-a） on ovarian reserve function and pregnancy outcome in patients with ovarian cyst. Methods From July 2013 to July 2015 in People＇s Hospital of Linqu County, 120 cases of ovarian cyst patients according to whether surgery combined treatment were divided into observation group and control group, each group of 60 cases. And observation group according to the operation type can be divided into bilateral cyst nucleus excision group and unilateral cyst nucleus observation group, with 30 cases in each group. Sinus follicle number, GnRH-a used days, gonadotropins （Gn） count, E2 level of human ehorionie stimulating gonadotropin （HCG）, follicle number, number of follicles, the number of eggs, the number of embryos, the number of frozen, the number of transplants, the rate of pregnancy, the rate of abortion, the rate of delivery and the rate of implantation of each groups were compared. Results Compared with bilateral cyst nuclear observation trial group, in bilateral cyst nuclear excision control group, number of follicles, the number of sinus follicle, E2 level of human chorionic stimulating gonadotropin （HCG）, follicle number, number of follicles, the number of eggs, the number of embryos, the number of frozen, the number of transplants were all reduced, and Gn count was increased, with statistical difference （ P 〈 0. 05 ）. The difference of the rate of pregnancy, the rate of abortion and the rate of delivery between bilateral cyst nuclear excision trial group and bilateral cyst nuclear excision control group had no statistically significant （P 〉 0. 05）. Compared with unilateral cyst nuclear excision group, in unilateral cyst nuclear excision combined with GnHR-a trial group, sinus follicle number, number of follicles and the number of eggs were reduced, while Gn count was increased, with statistical difference （ P 〈 0.05 ）. The difference of E2 level of human chorlonic stimulating gonadotropin （HCG） , the number of embryos, the number of frozen, the number of transplants, the rate of pregnancy, the rate of abortion and the rate of delivery between unilateral cyst nuclear excision combined with GnHR-a trial group and unilateral cyst nuclear excision group had no statistically significant （P 〉 0. 05）. Conclusion Unilateral or bilateral nuclear cyst excision can affect ovarian reserve function, combined with GnHR-a treatment can obviously improve reproductive function, and does not affect fertility, which should be paid more attention by medical workers.