腹腔镜治疗子宫内膜异位症合并不孕患者术后辅助药物治疗对受孕和妊娠影响

Effect of Postoperative Adjuvant Drug Therapy on Pregnancy and Pregnancy in Laparoscopic Treatment of Endometriosis with Infertility

目的:研究腹腔镜治疗子宫内膜异位症合并不孕患者术后辅助药物治疗对其受孕和妊娠的影响。方法:选取2015年1月-2017年1月本院子宫内膜异位症合并不孕患者150例。按照随机数字表法将其分为A、B、C组,各50例。三组均接受腹腔镜手术治疗,术后A组给予促性腺激素释放激素激动剂(Gn RHa)治疗,B组给予孕三烯酮治疗,C组不予药物治疗,A、B组均治疗3个月。三组均进行随访,比较三组及不同分期患者术后妊娠率与妊娠结局。结果:术后随访结果显示受孕88例(58.7%)、未受孕62例(41.3%)。其中妊娠者年龄22~40岁,平均(28.8±3.6)岁;受孕方式:辅助生殖15例、自然妊娠73例;手术结束直至受孕时间平均(10.6±4.5)个月;停药直至受孕时间(5.2±1.1)个月;不良妊娠者33例(37.5%)、顺利分娩55例(62.5%)。不同分期者妊娠率、不良妊娠结局发生率比较差异均无统计学意义(P>0.05)。A组受孕39例(78.0%),均高于B、C组的26例(52.0%)、23例(46.0%),比较差异均有统计学意义(P<0.05);A组不良妊娠结局发生率均低于B、C组,比较差异均有统计学意义(P<0.05)。结论:子宫内膜异位症合并不孕患者腹腔镜手术后接受Gn RHa治疗,能有效提升其受孕率并改善其妊娠结局,同时其对不同病情分期的子宫内膜异位症患者均有良好促孕效果,值得临床推广。

Objective：To investigate the effect of adjuvant drug therapy on pregnancy and pregnancy in laparoscopic treatment of endometriosis with infertility.Method：A total of 150 patients with endometriosis combined with infertility treated with laparoscopic surgery in our hospital from January 2015 to January 2017 were selected.According to the random number table method,they were divided into group A,B and C,50 cases in each group.They were treated with laparoscopy,group A was treated with gonadotropin-releasing hormone agonist（Gn RHa）,group B was given Gestrinone,group C was not treated,and group A and B were treated for 3 months.All three groups were followed up,postoperative pregnancy rate and pregnancy outcome were compared between three groups and different stages.Result：Follow up results showed that 88 cases（58.7%） were pregnant and 62 cases（41.3%） did not conceive.Among them,the pregnant age was 22-40 years old,average（28.8±3.6） years old;pregnancy way：15 cases of assisted reproduction and 73 cases of natural pregnancy;the operation ended until the time of pregnancy（10.6±4.5） months;the drug stopped until the time of pregnancy（5.2±1.1） months;33 cases（37.5%） of adverse pregnancy and 55 cases（62.5%） of successful delivery.The pregnancy rate and incidence of adverse pregnancy outcomes among different stages were compared,the differences were not statistically significant（P〈0.05）.39 cases（78.0%） of pregnancy in group A were all higher than 26 cases（52.0%） and 23 cases（46.0%）of group B and C,the differences were statistically significant（P〈0.05）,and the incidence of adverse pregnancy outcome in group A were lower than those of B and group C,the differences were statistically significant（P〈0.05）.Conclusion：Endometriosis combined with infertility patients receiving Gn RHa after laparoscopic surgery can effectively improve their pregnancy rate and improve their pregnancy outcomes.At the same time,they have good results in patients with different stages of endometriosis.The pregnancy effect is worthy of clinical promotion.