腹腔镜联合夫精宫腔内人工授精治疗子宫内膜异位症伴不孕症临床疗效观察

Clinical observation of laparoscopy combined with intrauterine insemination in the treatment of endometriosis joint with infertility

目的:探讨腹腔镜联合夫精宫腔内人工授精治疗子宫内膜异位症伴不孕症的临床疗效。方法:选取2010年1月~2016年6月120例子宫内膜异位症伴不孕症患者,随机将其分成对照组和观察组,每组各60例患者,其中对照组患者给予腹腔镜治疗,术后期待妊娠6个月,观察组患者在腹腔镜治疗基础上给予夫精宫腔内人工授精治疗6个周期,比较两组患者的临床结局和累计妊娠率情况。结果:观察组患者IUI过程中HCG日E2为(642.8±312.2)pmol/L,HCG日P为(0.39±0.19)ng/m L,子宫内膜厚度为(10.11±2.00)mm;观察组患者周期临床妊娠率(16.9%)显著高于对照组患者(6.1%),观察组子宫内膜异位症Ⅲ-Ⅳ期患者周期临床妊娠率(15.9%)显著高于对照组患者(3.5%)(P<0.05);观察组患者术后6个月累计妊娠率(23.3%)显著高于对照组患者(11.7%)(P<0.05)。结论:腹腔镜联合夫精宫腔内人工授精显著提高子宫内膜异位症伴不孕症患者的临床妊娠率,尤其是子宫内膜异位Ⅲ-Ⅳ期患者,值得临床推广应用。

Objective： To investigate the clinical effect of laparoscopy combined with intrauterine insemination in the treatment of endometriosis associated with infertility. Methods： From January 2010 to June 2016,120 infertile patients with endometriosis were randomly divided into control group and observation group,60 patients in each group. The control group was treated with laparoscopic treatment,then waiting for 6 months for pregnancy. The patients in observation group were given laparoscopic treatment based on intrauterine insemination of 6 cycles of treatment. Clinical outcome and cumulative pregnancy rate of the two groups were compared. Results： In observation group,during IUI,E2 was（ 642. 8 ± 312. 2） pmol/L,P was（ 0. 39 ± 0. 19） ng/m L,and endometrial thickness was（ 10. 11 ± 2. 00） mm. The pregnancy rate of patients in the observation group（ 16. 9%） was significantly higher than that of control group（ 6. 1%）. The clinical pregnancy rate per cycle（ 15. 9%） of patients with stage Ⅲ-Ⅳ endometriosis in observation group was significantly higher than that of control group（ 3. 5%）（ P〈0. 05）. The cumulative pregnancy patients rate（ 23. 3%） in observation group after 6 months was significantly higher than that of control group（ 11. 7%）（ P〈0. 05）. Conclusions： Laparoscopy combined with intrauterine insemination significantly improve pregnancy rateof infertile patients with endometriosis,especially in patients with stage Ⅲ-Ⅳ endometriosis,which is worthy of clinical application.