改良腹腔镜囊肿剥除术治疗卵巢子宫内膜异位囊肿致不孕症的临床研究

Clinical Study of Modified Laparoscopic Oophorocystectomy in the Treatment in Patients with Infertility Caused by Ovarian Endometriosis Cyst

目的:探讨改良腹腔镜囊肿剥除术治疗卵巢子宫内膜异位囊肿致不孕症的临床效果。方法:选择2018年1月-2019年12月笔者所在医院妇产科收治的100例卵巢子宫内膜异位囊肿致不孕症患者,根据手术方式分组,以实施传统腹腔镜囊肿剥除术的50例患者作为对照组,以实施改良腹腔镜囊肿剥除术的50例患者作为观察组。术后随访6个月,比较两组手术相关指标、临床妊娠率及复发率、视觉模拟评分法(VAS)疼痛评分、卵巢储备功能指标[促黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)]及肿瘤标志物[糖类抗原125(CA125)、糖类抗原72-4(CA72-4)、人附睾蛋白4(HE4)]。结果:两组手术相关指标比较差异无统计学意义(P>0.05)。观察组的临床妊娠率[42.00%(21/50) vs 24.00%(12/50)]明显高于对照组(P<0.05),复发率[6.00%(3/50) vs 16.00%(8/50)]明显低于对照组(P<0.05)。术后6个月,两组的痛经、性交痛及盆腔疼痛VAS评分均较术前明显降低(P<0.05),且观察组更低(P<0.05);两组血清LH、FSH、E2水平均较术前明显降低(P<0.05),且观察组更低(P<0.05)。结论:相对于传统腹腔镜囊肿剥除术,改良腹腔镜囊肿剥除术更能有效改善卵巢子宫内膜异位囊肿致不孕症患者的疼痛症状及卵巢储备功能,降低复发率,提高临床妊娠率。

Objective:To investigate the clinical effect of modified laparoscopic oophorocystectomy on the treatment in patients with infertility caused by ovarian endometriosis cyst.Method:A total of 100 cases of patients with infertility caused by ovarian endometriosis cyst who were selected in the department of obstetrics and gynecology of our hospital from January 2018 to December 2019.A total of 50 patients undergoing traditional laparoscopic oophorocystectomy were taken as the control group and 50 patients undergoing modified laparoscopic oophorocystectomy were taken as the observation group according to the methods of surgery.All the patients were followed up for 6 months.The intraoperative related indexes,clinical pregnancy rates,recurrence rates,visual analogue scale (VAS) pain scores,ovarian reserve function indexes[luteinizing hormone (LH),follicle-stimulating hormone (FSH),estradiol (E2)]and tumor markers carbohydrate antigen-125 (CA125),carbohydrate antigen 72-4 (CA72-4),human epididymal protein 4 (HE4) were compared between the two groups.Result:There were no significant differences on intraoperative related indexes between the two groups (P>0.05).The clinical pregnancy rates[42.00% (21/50) vs 24.00% (12/50)]in the observation group were significantly higher than that in the control group (P<0.05),the recurrence rates[6.00% (3/50) vs 16.00% (8/50)]was significantly lower than that in the control group (P<0.05).Six months after surgery,dysmenorrhea,dysmenorrhea and pelvic pain VAS scores in both groups were significantly reduced compared with those before surgery (P<0.05),and the reduction was significant lower in the observation group (P<0.05).The serum levels of LH,FSH,E2 in both groups were significantly reduced compared with those before surgery (P<0.05),and the reduction was significant lower in the observation group (P<0.05).Conclusion:Compared with traditional laparoscopic oophorocystectomy,modified laparoscopic oophorocystectomy was more effective in improving the pain symptoms and ovarian reserve function of patients with infertility caused by ovarian endometriosis cyst,reducing the recurrence rate and improving the clinical pregnancy rate.